Medical Authorization Forms

Medication Requirements 

Medications are NOT allowed on campus without a completed Medication Authorization Form.

A new form is required each school year and must be signed by both the parent/guardian and healthcare provider.

Medications must be stored in the health office and managed by staff, unless approved for self-carry.

Self-carry requires provider authorization, and students must be age-appropriate and able to manage their medication responsibly. For self-carry, the provider must confirm the student is trained and proficient in safe use.

Physician orders may be submitted on office forms or letterhead; the parent portion of the Medication Authorization Form must still be completed (indicate “See attached orders”).

Additional Required Health Forms for students with any of the following medical conditions:

Allergies/Food Allergies: FARE or Allergy/Anaphylaxis Action Plan (if your child uses an EpiPen)

Asthma: Asthma Action Plan (AAP)

Seizures: Seizure Action Plan (SAP) 

Diabetes: Diabetic Medical Management Plan (DMMP) – updated annually or with changes

Kaiser, LCPH/Stanford, UCSF, or Sutter action plans may be substituted for these forms.

Please complete and submit the appropriate forms along with the medication to the school office. If you have any questions, feel free to contact us—we’re happy to help!