Action Plans

A NOTE FROM THE NURSING DEPARTMENT
Forms have been revised for the school year 2020-2021 and will be available in June. The school year officially begins July 1st and all the medical forms will need to be completed by a physician/healthcare provider on or after July 1st. 
Stay well, Stay safe, Enjoy your summer. 
LVA Certified School Nurses


Some students have certain medical conditions (food allergies, asthma, bee sting allergies, diabetes, seizures) that can cause them to have a severe reactions and or medical events at school. School nurses often request additional information from the student's physician regarding their particular condition to help the nurse better care for the student at school.

Should a student require medical care at school for food/insect allergies, asthma and/or seizures, an action plan and Authorization for Medication During School Hours form must be completed by the student’s physician and parent/guardian and submitted to the Certified School Nurse.

Allergy and Anaphylaxis
DOWNLOAD ALLERGY FORMS

Asthma
DOWNLOAD ASTHMA FORMS
 

Diabetes
DOWNLOAD DIABETES FORMS

To ensure that the diabetes management needs of students are met, please work with the student’s health care provider to obtain the necessary action plan and medication orders.


Seizure
DOWNLOAD SEIZURE FORMS