Student Health Annual Update Checklist

All Students Should Have the Following Information on File:


  • Emergency contact card with health information (on back of card)
  • A06 Screen with health conditions
  • Health Screenings
  • Immunizations


Students Who Require Health Interventions at School are Required to Have on File:


  • Authorization for Medication/Treatment Form- Students who receive medications or medical procedures at school.
  • Diabetes Medication/Treatment Authorization Form; Insulin Pump Medication/ Treatment Form (if appropriate); Parent and School Responsibilities Form; and Diabetes Emergency Care Plan – Students with Diabetes will require these forms to authorize the routine and emergency care at school.
  • Student Health Care Plan – Students with health conditions may require a health care plan completed by the on-site or on-call school nurse. This plan provides information on the management of the student’s health condition for school staff. This health plan should be shared with school staff that have a legitimate interest in having this information for the student’s safety and well-being and the information should be accessible to school staff involved with the student’s care.