Student Health Services / Medical Forms

Student Health Information Form (to be completed each year)

Health Form.pdf 287.25 KB (Last Modified on June 16, 2015)

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Asthma History and Needs Assessment

Asthma History and Needs Assessment.pdf 23.40 KB (Last Modified on June 16, 2015)

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Asthma Action Plan

Asthma Action Plan.pdf 39.70 KB (Last Modified on June 16, 2015)

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Permission Form for Student to Self-Administer Medication

Permission for students to self-administer medications to themselves. This form is to be signed by a parent.

Permission to self administer meds.pdf 35.33 KB (Last Modified on June 16, 2015)

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Permission Form for Medications

Students needing to take medication during school hours will need to have this form completed by a physician and signed by a parent.

Administration of Meds to Student.pdf 61.24 KB (Last Modified on June 16, 2015)

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Food Allergy Assessment Form

Food Allergy Assessment form.pdf 1.98 MB (Last Modified on June 12, 2017)

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Food Allergy Action Plan

Food Allergy Action Plan.pdf 1.01 MB (Last Modified on June 12, 2017)

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Bee or Insect Allergy Form

Bee or Insect Allergy Form.pdf 1,017.62 KB (Last Modified on June 12, 2017)

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Houston R-1 School District