- Holman Elementary School
- Health Paperwork
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Self-Administration Form
Please fill out and sign the self-administration form if the student is able to self administer Epi-pen/Auvi-Q in an emergency situation. Please have the doctor fill out Physician for Self Administration form.
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Medication Administration Form
If you child needs any medications at school, please have the doctor fill out the form provided below. This includes over the counter medications, the school nurse is unable to administer any medications without the form and proper medications provided. The parent must provide the medication for the school nurse. Students are unable to carry any medications in their back packs at school, medications must be held in the nursing office, unless otherwise specified.
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Allergy Treatment Plan
If your child has allergies, please have the doctor fill out the Allergy Treatment Form as well as the Individual Emergency Health Care Plan. Parent must bring in proper medication as well as completed forms. For your childs saftey a delegate will be assigned to your child. In the event of an emergency where the nurse is not available the delegate will be able to administer Epipen/Auvi-Q. If you have any questions or concerns please call me!