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Medication Request Form
This form is required for each medication to be taken at school (in addition to forms below, as appropriate)
Metered dose inhalers (MDI) are preferred over nebulized treatments in the school setting.
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Activity/Trip Medication Form
** Use this form if medication needs to be given during a school trip and the medication is not already on file with the school nurse (such as when departure time occurs before the start of the school day).
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Asthma Action Plan
Physician form regarding management of asthma symptoms.
Metered dose inhalers (MDI) are preferred over nebulized treatments in the school setting.
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Asthma Inhaler - Self-carry Form
Parent & Physician permission form for a student to self-carry an asthma inhaler at school.
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Required Parent Acknowledgement & Consent Form for School Diabetes Management
Required supplement to your student's annual Diabetes Management & Treatment Plan
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Diabetes Medical Management Plan
Diabetes treatment plan template for providers (from the American Diabetes Association) with key components necessary for outlining care at school
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Seizure Management & Treatment Plan (State Required Form)
Parent & Physician form for management and treatment of a student with seizures.
**This specific form is required for seizure management at school. Other forms from healthcare providers will no longer be accepted per Senate Bill (SB) 1506, 88th Texas Legislature, 2023.
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Parent Acknowledgement & Consent Form for Seizure Management @ School
This form is a Prosper ISD required supplement to a student's Seizure Management Plan for school care.
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Severe Allergy Parent Checklist
Parent checklist of required documents and items for school management of known severe allergies.
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Anaphylaxis Emergency Plan & Authorizations
Annual parent & physician form for management of a student's severe allergies. Includes section for permission to self-carry epinephrine.
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Special Dietary Needs Form
Form for physician requested student specific dietary substitutions in the school cafeteria line.
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Adrenal Insufficiency Treatment Plan
Parent & Physician form for management of a student with adrenal insufficiency.
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Gastrostomy & Tube Feeding Management Plan
Parent & Physician form for management of gastrostomy and nasogastric tubes/feedings in the school setting.
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Supplemental Oxygen
Parent & Physician form for management of a student requiring supplemental oxygen therapy in the school setting.
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Tracheostomy Management Plan
Parent & Physician form for care and management of a student with a tracheostomy.
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Other Specialized Health Care Request
Parent & Physician form for specialized health care not specified on other forms.
