Medical Form 504
Fri, Sep 25 12:58pm

If a student needs prescribed  medication held by our school nurse, that may be administered during the school day, either regularly or in an emergency,  please give this form 504 to the doctor to fill out. This includes food allergies /epi-pens, students with juvenile diabetes, and any other medication that is prescribed by a doctor that may be administered during school hours.


  • Please return the form to the teacher in a manilla envelope clearly marked with the childs name.
  • In the envelope, include the medication  with the prescription  in a  ziplock bag labeled with the child's name, class/cohort and teacher. If you would like the teacher to have an epi-pen in the classroom, place it in a seperate labeled ziplock in the manilla envelope. At least 100 staff members are trained in the use of epi-pens at this time. More trainings will be available for new staff members in the coming weeks.