Health Services » Nurse Forms

MEDICATION AUTHORIZATION

• Authorization to administer

LIFE THREATENING ALLERGY CARE PLAN

Anaphylaxis care plan and Medication orders for students with orders for
epinephrine

• Anaphylaxis Care Plan and Medication Orders

ALLERGY CARE PLAN - NOT LIFE THREATENING

Allergy care plan with orders for Benadryl or other medication if needed-no
epinephrine

• Allergy Assessment Bee or Insect Form

• AllergyAssessmentFoodForm

ASTHMA EMERGENCY CARE PLAN

• Asthma Care Plan and Medication Orders

CARDIAC EMERGENCY CARE PLAN

Cardiac care plan for students with a heart condition

• Cardiac Care Plan ECP

DIABETES EMERGENCY CARE PLAN

Diabetes care plan for those that inject insulin, use an insulin pump, and have a hybrid closed loop system

• Diabetes Orders

SEIZURE EMERGENCY CARE PLAN

Seizure care plan and medicaiton orders if indicated

• Seizure Form

• Seizure History