Health Services Overview

Documents & Forms

Emergency Resources

Financial Assistance

Health Educational Resources

Telehealth, Vision & Dental

Recognize Excellence

Required Form

Clinic Form

Required Forms, when applicable

Authorization for Two-Way Communication

Permission for My Child to Carry Inhaler, EpiPen and/or Diabetes Medicine

Permission for My Child to Receive Medication at School

Vaccine Form: Religious Waiver

Eye, Ear, Dental and Nutrition Screening Forms

Consent Forms

Student Accident Insurance Plan Forms

Information about Student Accident Insurance Plans

Student Accident Insurance Plan (English)

Información sobre Planes de Seguro de Accidentes para Estudiantes

Student Accident Insurance Plan (Plan de seguro de accidentes para estudiantes-Spanish)

Dental Forms

Dental Services Consent Form - English

Dental Service Consent Form - Spanish

Telehealth Services Consent Forms (these can also be completed electronically at pickenscare.com)

Download the Minor Consent Form

Download the HIPAA form

Miscellaneous Forms

Scoliosis Screening Forms

Plans of Care

Allergy Plan of Care

Asthma Plan of Care

Attention Deficit Disorder (ADD/ADHD) Plan of Care

Cardiac Plan of Care

Catheterization Plan of Care

Diabetes Plan of Care

Encopresis Healthcare Plan

Generic Plan of Care

Physician Orders for Special Health Procedures

Seizure Plan of Care