Student Health Forms
For students new to Providence Academy, the following health forms are required prior to starting the school year.
Medication At School
All medication must be kept in the health office during the school day. Students need a signed medication authorization form to receive medication from the health office. These forms are submitted yearly. Acetaminophen and ibuprofen may be given to students in grades 6-12 with a parent signature. All other medications, prescription or over-the-counter, require physician and parent signature. EpiPens and albuterol inhalers may be self carried when a medication authorization is on file. Albuterol inhalers for students in Lower School are kept in the health office.
Please submit an updated copy of your child’s Asthma Action Plan and the Asthma Individual Health Plan each year. Students in grades 6-12 who self carry their albuterol will need to complete the Student Inhaler Agreement. If your physician has not provided you with an Asthma Action Plan and your child may need albuterol or other medication for their asthma, please complete the medication authorization form.
Please submit an updated copy of your child’s Anaphylaxis Action Plan and Allergic Reaction Questionnaire each year. If your physician’s office has their own version of the Anaphylaxis Action Plan, that is acceptable.
Please submit an updated Treatment Authorization Form from your child’s physician each school year. A meeting with the school nurse will be arranged before the start of the year. In addition, parents will complete a new Diabetic Emergency Plan each year.
Please submit an updated copy of your child’s Seizure Action Plan and Parent Questionnaire each year.