Forms

Annual Student Health Information

Every student should have an updated and completed Student Health Information form on file with the school nurse EACH year.  

Información Médica Anual Del Estudiante

Cada estudiante debe tener un formulario de información de salud del estudiante actualizado y completado en el archivo de la enfermera de la escuela CADA año. 

Permission to Administer Medicine

Complete this form and bring with your student's medication to the School Nurse or designated staff member. Reminder: students may not transport medication to school. 

Autorización Para Administrar Medicamentos

Rellene este formulario y llévelo con la medicación de su estudiante a la enfermera de la escuela o al miembro del personal designado. Recordatorio: los estudiantes no pueden transportar medicamentos a la escuela. 

Authorization to Carry a Prescription

Have your physician or provider complete this form to allow your student to have an epi pen, inhaler, or diabetic supplies on their person. 

Special Dietary Needs Form

Complete this form for food sensitivies & allergies. 

Medical Policy/Parent Letter

The Health Services letter details and summarizes the health policies for Effingham County Schools. You can learn more about our department and the services it offers. 

Religious Exemption Form for Immunizations

Required documentation for immunization waiver. Must be notarized.

Children's Dental Health

Help A Child Smile Parent Letter & Form 

Form 4400: Certificate of Scoliosis Screening

Required for students entering 6th and 8th grade. 

Anaphylaxis Action Plan

For life threatening allergic reaction; accompanies an epinephrine injection prescription (Epi Pen, Epi Pen Jr, AuviQ, etc). Must be completed and signed by your child's physician or provider. 

Asthma Action Plan

For the chronic condition of asthma; accompanies an emergency inhaler (albuterol, etc). Must be completed and signed by your child's physician or provider. 

Diabetes Action Plan

Required for diabetic students. Completed by your child's physician or provider. Gives guidance on the management of the diabetic student while in school. 

Food Allergy Action Plan

For students with allergies to food. May accompany an anaphylaxis action plan as well. Completed by your child's physician or medical provider. 

Seizure Action Plan

For students with seizures; accompanies emergency medications kept in the clinic. Completed by your child's physician or medical provider.