All forms are highlighted in red. Please email completed forms to the school nurse at
emetzger@southlakechristian.org or submit in person to the school when classes resume.
Anaphylaxis requiring an EpiPen:
Please have an
Food Allergy Action Plan completed by your physician and submitted to school by the first day of classes. Students in JK-5th grade should have a set of EpiPens provided to the school along with the form. Students in grades 6-12th are encouraged to carry their own EpiPen and emergency supplies. They will need to complete a
Self-Carry Medications Contract.
Asthma requiring access to an inhaler:
Please have an
Asthma Action Plan completed by your physician and submitted to the school by the first day of classes. See above under Anaphylaxis instructions regarding age at which they may self-carry their inhaler and the needed form to do so.
For other medical conditions:
Other medical conditions such as diabetes (
Diabetes Emergency Action Plan), epilepsy (
Seizure Action Plan), etc. please contact me by email. We will need to discuss your child's individual needs and ensure the general plans attached meet your child's needs.
If your child will be needing medication during school hours, please have your health provider complete the Authorization for Medication Administration. This would include any midday ADHD medications, allergy medications, or as needed medications for various conditions that you would want available to be administered at school. This form and the authorized medication in original prescription or manufacturer's packaging may be submitted to the school when classes resume.
