Medical Forms


MANDATORY HARD COPY FORMS


Confidential Health History Update

All new and returning families must complete this form for each student . Fillable form should be completed, printed, signed and a returned to the school nurse. Questions? Email: nurse@stmschool.org for assistance.


School Entrance Health Form/Immunization Record

All Pre-K, Kindergarten, and new families must download this form, have it completed by a healthcare professional, and return it to the school nurse. 



FORMS TO COMPLETE only if APPLICABLE


Severe Allergy Action Plan

Download and complete for students with severe food/insect allergies- MD/NP/PA signature required and MUST accompany Epi-pen and Antihistamine forms below.


Asthma Action Plan

Download and complete only if your student requires an inhaler. Must accompany inhaler form below.

Inhaler Administration Form

Download and complete only if your student requires an inhaler. Must accompany Asthma Action Plan form above. 

Antihistamine Form

Download and complete if applicable.

Epi-Pen Form

Download and complete if applicable.

Medication Authorization Form

Please complete and deliver with either over-the-counter or prescription medication to the clinic as needed. Prescription medication requires MD/NP/PA signature. Forms and medication sent in with students will not be accepted – a parent or guardian must accompany this form.