Hopkins School District #270

If your child has a significant or life-threatening allergy requiring emergency epinephrine treatment, please complete this form and contact your school nurse.

Si su hijo tiene alguna alergia significativa o que ponga en peligro su vida, requiriendo de emergencia que se le suministre epinefrina, por favor complete este formulario y contacte a la enfermera de su escuela.

(If your child has a significant or life-threatening allergy requiring emergency epinephrine treatment, please complete this form and contact your school nurse.)

Please complete this form, along with the Asthma Action Plan, if your child has asthma.

Please complete this form, along with the Asthma Parent Questionnaire, if your child has asthma.

Por favor complete este formulario junto con el Plan de Acción en caso de Asma, si es que su hijo tiene asma. (Please complete this form, along with the Asthma Action Plan, if your child has asthma.)

Por favor complete este formulario junto con el Cuestionario sobre el Asma para Padres, si es que su hijo tiene asma. (Please complete this form, along with the Asthma Parent Questionnaire, if your child has asthma.)

Please complete this form if your child has asthma.

Please sign the consent form to enable your child to receive all the designated health services offered by the licensed school nurse and the nurse's health assessment. Health assessments are performed only under the supervision of a licensed school nurse. The assessment may include: weight, vision, hearing, blood pressure, scoliosis, and a general health history for those children needing special help.

Favor de firmar el formulario de autorización, para permitir que su hijo reciba todos los servicios médicos señalados, ofrecidos por la enfermera de la escuela.

Please complete, along with the Diabetes Medical Management Plan, if you child has diabetes.

Please complete, along with the Diabetes Healthcare Plan, if you child has diabetes. Your health care provider's signature is required.

Please complete this form and return to school with your child's enrollment forms. The form provides the school nurse emergency contact and health information.

Por favor complete este formulario y regréselo a la escuela junto con los formularios de inscripción de su hijo. Este formulario le proporciona a la enfermera de la escuela información del estado de salud y contactos en caso de emergencia. (Please complete this form and return to school with your child's enrollment forms. The form provides the school nurse emergency contact and health information.)

Minnesota Statutes Section 121A.15 requires children enrolled in a Minnesota school to be immunized against certain diseases, allowing for specified exceptions. This form is designed to provide the school with information required by the law.

Registro de vacunación del alumno. La Sección 121A.15 de los Estatutos de Minnesota requiere que los niños inscritos en una escuela de Minnesota estén vacunados contra ciertas enfermedades, permitiendo excepciones específicas. Este formulario ha sido creado para proporcionar a la escuela la información que requiere la ley.

Parents/guardians asking school staff to give medications to their child must complete this form and have the  health care provider sign every school year.

For a student to self administer asthma medication. this form must be completed by the prescribing health professional, along with the Medication Agreement by the student and the parent/guardian.

For a student to self administer asthma medication. this agreement must be completed, along with the Medical Authorization by the prescribing health professional and  the parent/guardian.

Complete this form if your child has lactose intolerance and requires lactose-reduced milk at mealtimes.

If you are requesting any special dietary requests for your child, please have your health care provider complete the Special Diet Medical Statement.

The physical examination is recommended when your child enters kindergarten and seventh grade.

Please complete, along with the Seizure Action Plan, if your child experiences seizures.

Please complete, along with the Seizure Parent Questionnaire, if your child experiences seizures.The form needs the signature of your health care provider.