Health Forms and Information

These health forms will allow the ÁùºÏ±¦µä ISD Health Services team to provide care for your student while at school. 

(Select a topic to expand)

Only medications that are necessary for a student’s medical care will be administered at school. Most medicines that are needed, even up to three times a day, can be given at home and should not be sent to school. 

There are some occasions where medication is required by students and cannot be adequately given at home. In these cases, with written permission of a parent or guardian, designated care staff can give the medication. 

A physician's signature is required for all medications that will be given at school to include the following:

  • Daily medication(s) for a prescription
  • Over-the-Counter medication(s) to be stored at school 
  • Over-the-Counter medication(s) to be administered at a dose different from the manufacturer's label

If your student requires medication at school, please complete the form:

  • ÁùºÏ±¦µä ISD Request to Administer Medication at School - English/Spanish

Only a parent or guardian may drop off and pick up medication at the nurse’s office. Students are not allowed to carry medication with them in school or on the bus. Unused medication will be discarded after 30 days.

Medication must be in its original container. The school nurse will not accept or administer any medications that are in Ziploc bags or improperly labeled bottles. No mixtures of medication are accepted (i.e. Tylenol 500 mg and 250 mg in one container). Please make sure the medication has not reached the expiration date on the bottle.

Please make arrangements so the medication can be left at the nurse’s office until the last day the medication is to be given. If the pharmacist is unable to prepare a separate container for home and school, keep enough medication for home use and bring the rest to the school in the original prescription bottle.

If non-prescription medications are required longer than one week, have the physician write an order to keep in the nurse’s records.

Students with prescription asthma or anaphylaxis medication may possess and self-administer their medication following rule 38.15 of the Texas Education Code. This will require written permission from their doctor stating that the student may self-administer. It will be kept on file in the nurse’s office and is valid for the current school year only.

If your child wears contact lenses, she/he should keep a case and small solution bottle in her/his locker or backpack. Using their own supplies reduces the risk of eye infections.

For students with anaphylaxis to food, insects, or other substances, please use one 

of these forms

  • Food Allergy and Anaphylaxis Emergency Care Plan - English
  • Food Allergy and Anaphylaxis Emergency Care Plan - Spanish

Guidelines for the Care of Students With Food Allergies At-Risk for Anaphylaxis 

ÁùºÏ±¦µä ISD’s Food Allergy and Anaphylaxis Emergency Care Plan was developed to care for students with a diagnosed or undiagnosed potentially life-threatening allergy at risk for anaphylaxis, a life-threatening allergy response.

Anaphylaxis is a serious immune-mediated response that develops after ingesting or coming in contact with allergens such as foods, insect stings, latex, or medications. Anaphylaxis may occur within minutes and up to 2 hours after exposure to an allergen.

This Emergency Care Plan is in compliance with Texas S.B 27 and 66 as outlined by the . 

ÁùºÏ±¦µä ISD will follow an individualized health plan (IHP) for students with food allergies upon receipt of signed medical plans and parental consent forms.

The IHP involves cooperation and communication between students, parents, student’s physician, school nurse, counselor, food services, and other ÁùºÏ±¦µä ISD personnel as needed:

  • ÁùºÏ±¦µä ISD requires annual compliance training to teach all staff to recognize an allergic reaction and how to use rescue drugs such as epinephrine auto-injectors. 
    • In the case of severe life threatening allergies, elementary school nurses will send letters to other parents of the class requesting parents to voluntarily refrain from sending the allergen food in their child’s belongings during school or after-school activities, celebrations or parties. 
  • The principal will designate a food-allergy friendly area or lunch table. Hand washing guidelines for staff and students will be enforced. 
  • The custodial department will be instructed to use commercial wipes and cleaners that remove the allergen from the hard surfaces. Non-food items will be adapted in the curriculum for those classes who have students with food allergies. 
  • The transportation department will also be notified, and trained to recognize the specific reactions to life threatening allergies, if applicable. 

While ÁùºÏ±¦µä ISD cannot guarantee an allergy-free environment at school, the district is committed to doing everything possible to ensure the safety of every child who has allergies.

Some students have allergies that are triggered by certain foods and may lead to an anaphylactic reaction which can be life-threatening. When the school learns of such an allergy, it is important to respond in a manner to ensure the health of the student. ÁùºÏ±¦µä cannot guarantee that a student will never experience an allergy-related event while at school; however, in order to reduce the risk that children with food allergies will have an allergy-related event at school, the ÁùºÏ±¦µä Nutrition Policy–English - Spanish was created as outlined by 

For students with respiratory issues requiring an inhaler, please complete the following form:

  • ÁùºÏ±¦µä ISD Asthma Action Plan - English
  • ÁùºÏ±¦µä ISD Asthma Action Plan - Spanish

Please complete this form as authorization from the student's diabetes care provider.

  • Diabetes Care and Treatment Plan - English
  • Diabetes Care and Treatment Plan - Spanish

Under HB 984, every Texas school must train additional staff to serve as Unlicensed Diabetes Care Assistants who can provide diabetes management and care services if a nurse is not available when a student needs such services. Such services include the administration of insulin or, in an emergency, glucagon. 

ÁùºÏ±¦µä ISD has trained staff at each school to provide such services. HB 984 further specifies that an Unlicensed Diabetes Care Assistant exercises his or her judgment and discretion in providing diabetes care services and that nothing in the statute limits the immunity from liability afforded to employees under section 22.0511 of the Texas Education Code.

For students with a seizure disorder, please use this form:

  • Seizure Care -
  • Seizure Care -

Additional Health Forms

Special Diet

If your child has a food allergy or intolerance or a disability that restricts their diet, please complete this Special Meal Accommodation Form (Parts A & B). The form must also be signed by a licensed physician.

  • Request for Dietary Accommodations - English
  • Request for Dietary Accommodations - Spanish

For more information, visit; ÁùºÏ±¦µä ISD Nutrition and Food Services 

Special Procedures

If your student requires specialized health care, please use this form:

  • ÁùºÏ±¦µä ISD Authorization for Special Procedures Form - English