NUMBER

FORM

2

Allergic Reaction form

3

Homebound Application

4B

Transportation Application

5

Authorization for Meds (Asthma)

6

Blood and Body Fluid (emp.)

7

Blood and Body Fluid (student)

8

Children at Risk memo

9

Color Perception form

10

Chronic Disabling list

11

Temporary Disabling list

12a

Disclaimer (full)

12b

Disclaimer (1/4)

13

Doctors Order form

14

Field Trip form

15

Head Injury form

20

Health Services Information Sheet

21

Health Services Information Sheet (Sp.)

23

Individualized Healthcare Plan

26

Consent form to give Medication

27

Non-compliance Screening procedures

28

Pediculosis letter (classroom)

29

Pediculosis Letter (exclusion)

30

Scabies letter

31

Medicaid Reimbursement form

32

SCSD Medication record

33

SCSD Medication Log

34

Individual Health Office Visit Log

36

SCSD Diabetic Management Record

40

PE Excuse form

41

Physician's Letter/sports waiver

42

Pool Accident form

45a

Student PE form

45b

Student PE form (Sp.)

47

Procedure/Treatment Record

51

Hippa Release form

52

Hippa Release form (Sp.)

55

Monthly Report totals

57

Scoliosis Notice to Parent

59

Scoliosis Screening Worksheet

60

Scoliosis Referral form

62

Printed Material Order form

63

Waiver for contact sports (parent form)

64

Modified Physical Education form

SCSD Medication Administration Record

Exclusion Letters (Eng. And Sp.)