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Medical Forms
Allergy Plan
Allergy & Anaphylaxis – Emergency Action Plan
16 Jul 2020
Asthma Action Plan
Asthma Action Plan, Medication Authorization & Self-Administration Form
04 Jun 2020
Diabetes EAP
Diabetes Emergency Action Plan
01 Jun 2020
Diabetes IHP
Diabetes Individual Health Plan
01 Jun 2020
DMMO
Diabetes Medication/Management Orders
01 Jun 2020
IHP
Individualized Healthcare Plan
31 Jul 2018
Kindergarten Registration
2020-21 Kindergarten registration requirements
03 Mar 2020
Lice Treatment
Lice Treatment Letter
08 Dec 2017
Meal Requests
|Medical Statement to Request Special Meals, Accommodations, and Milk Substitutions
04 Dec 2018
Medication Authorization
Multiple medications to be administered at school
08 Dec 2017
Seizure Plan
Individualized Healthcare Plan/Emergency Action Plan
03 August 2020
SMMO
Seizure Medication Management Orders
03 August 2020
Vision Screening OPT-OUT Form
As allowed in UCA 53G-9-404 (2019) a parent may opt their student out of vision screening.
23 Aug 2019
Vision Screening Opt-Out form
Vision Symptoms Questionnaire
Utah Department of Health in accordance with UCA 53G-9-404
11 Sept 2019