Health Forms and Notices


CH205 Child Adolescent Health Examination Form

New Admission Examination Notice, with FAQ

New Admission Examination Appointment Notice, with FAQ

Health Insurance Information in ATS

OT/PT Medicaid Principal Protocol letter

OT/PT Parent Notification Letter

AED Program Checklist

Schedule CPR/AED Training for Your School

Health Director Contacts

The Facts about Head Lice

Lice Policy Memo

Individual Lice Letter

Class Lice Letter

School Based Health Center Parental Consent Form

School Flu Letter for Parents

Flu Information for Parents

504 Accommodations

Guidelines for the Provision of Health Services and/or Section 504 AccommodationsGeneral Medication Administration FormRequest for the Provision of Medically Prescribed Treatment (Non-Medication)Parent Request for Section 504 Accommodations with HIPAA Authorization FormMedical Review for 504 AccommodationsParent Letter – Renewal of 504 AccomodationsParent Letter – 504 Accommodations New StudentsNotice of Non-Discrimination under Section 504504 Accommodation Plan504 Accommodations Student and Family GuideNotice of Eligibility DeterminationAuthorization for Release of Health Information Pursuant to HIPAA

Allergy and Asthma

Parent Letter for Guidance for EpiPen ShortageAllergies/Anaphylaxis Medication Administration FormAllergy Response PlanMedical Review of Student with Severe AllergiesStanding Order for Administration of Epinephrine for NursesTraining Program for Unlicensed School-Personnel to Administer EpinephrineAsthma Medication Administration Form


        Diabetes Medication Administration Form

        Diabetes Medication Administration Form Addendum


        Immunization Chart for FamiliesImmunization Chart for ProvidersMedical Exemption Process for ImmunizationsMedical Request for Immunization Exception
        Religious Exemption ProceduresParent Letter to Request Exemption from ImmunizationsRequest for Review of Serology or Documentation of Varicella DiseaseSerology Review Process Guidelines for Entering Student Immunizations into ATSWarning Letter Regarding Immunization StatusExclusion Letter Regarding Immunization Status

                      Mental Health

                      Mental Health Consultant Program Backpack LetterSuicide Prevention FlyerMaking Educators Partners HandoutMental Health First Aid Handout"There's Help All Around You" flyer


                      Eye Report and Recommendation Form (E12S)Vision Screening Policy StatementVision Screening HandoutVision Screening Letter to ParentsResults of Vision Screening LetterResults of Vision Screening Follow-Up Letter

                      Oral Health

                      School-based Health Center Dental Policy and Procedures

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