- Prosper ISD
- Forms
Medication Forms
-
Medication Request Form
This form is required for each medication to be taken at school (in addition to forms below, as appropriate)
NEBULIZER TREATMENTS WILL NOT BE ADMINISTERED IN THE SCHOOL SETTING WHILE COVID-19 RESTRICTIONS ARE IN PLACE.
Asthma Forms
-
Asthma Action Plan
Physician form regarding management of asthma symptoms.
NEBULIZER TREATMENTS WILL NOT BE ADMINISTERED IN THE SCHOOL SETTING WHILE COVID-19 RESTRICTIONS ARE IN PLACE.
-
Asthma Inhaler - Self-carry Form
Parent & Physician permission form for a student to self-carry an asthma inhaler at school.
Diabetes Forms
-
Diabetes Management & Treatment Plan (Insulin Pump)
Parent & Physician form for management of diabetes for a student with an insulin pump.
-
Diabetes Management & Treatment Plan (Multiple Daily Injections)
Parent & Physician form for management & treatment of diabetes of student with diabetes receiving multiple daily injections of insulin.
-
Additional Required Annual Diabetes Forms
Includes Unlicensed Diabetes Care Assistant form and Parent/Student Responsibilities form.
Severe Allergy Forms
-
Severe Allergy Parent Checklist
Parent checklist of required documents and items for school management of known severe allergies.
-
Anaphylaxis Emergency Action Plan
Annual parent & physician form for management of a student's severe allergies. Includes section for permission to self-carry epinephrine.
-
Special Dietary Needs Form
Form for physician requested student specific dietary substitutions in the school cafeteria line.
Other Health Condition Forms
-
Adrenal Insufficiency Treatment Plan
Parent & Physician form for management of a student with adrenal insufficiency.
-
Gastrostomy & Tube Feeding Management Plan
Parent & Physician form for management of gastrostomy and nasogastric tubes/feedings in the school setting.
-
Seizure Management Plan
Parent & Physician form for management and treatment of a student with seizures.
-
Supplemental Oxygen
Parent & Physician form for management of a student requiring supplemental oxygen therapy in the school setting.
-
Tracheostomy Management Plan
Parent & Physician form for care and management of a student with a tracheostomy.
-
Other Specialized Health Care Request
Parent & Physician form for specialized health care not specified on other forms.