Health Room Information
Health Forms
Below are the Health Forms that Holy Infant requires all to students to have on file. If your child has asthma, food allergies, or takes medication during school hours, these Mandatory forms must be completed by your child's health care provider regardless of grade level. If you have any questions, please contact Mrs. Jennifer Stensland, RN at 636-227-0802, ext. 1
Asthma Action Plan - this form or similar form provided by the physician required for all students with asthma
Food Allergy Action Plan | required for all students who have food allergies
Consent for Self Carry - for those in 4th grade and up who may need to carry emergency medication themselves – requires physician signature
Consent for Prescription Medication Administration - required for all students who need to take prescription medication at school – parent must sign, but Rx label may serve as physician consent
Consent for OTC (Over the Counter) Medication Administration - required for ALL students who may need over the counter medication during the school day -- requires physician signature
