形式
卫生及健康服务表格
Some of these forms can be completed online, saved, and then attached to an email. Other forms must be printed then either scanned and emailed, faxed, or mailed.
- Annual Student Health Information Update
- Authorization for Medications Taken at School
- Authorization for Treatments and Procedures Performed at School
- Diet Prescription for Meals at School
- 非凡的护理支持
- Field Trip/Outdoor Education Information and Release
- 家庭/医院指令
- 免疫接种
- 发放医疗纪录(相互交流)
- 性健康教育
- Transportation for Medical Reasons
Annual Student Health Information Update
- Annual Student Health Information Update (Amharic)
- Annual Student Health Information Update (English)
- Annual Student Health Information Update (Simplified Chinese)
- Annual Student Health Information Update (Somali)
- Annual Student Health Information Update (Spanish)
- Annual Student Health Information Update (Tagalog)
- Annual Student Health Information Update (Vietnamese)
Authorization for Medications Taken at School
State and federal law requires that a form must be completed and signed by 这两个 parent/guardian and a licensed health care provider with prescriptive authority for 所有 medications to be given at school, including over-the-counter (OTC) medications. See Health-Related School Information for more detail. This form needs to be renewed at the beginning of each school year.
有过敏症的学生
食物过敏评估表格
- 食物过敏评估表格 (Amharic)
- 食物过敏评估表格 (English)
- 食物过敏评估表格 (Simplified Chinese)
- 食物过敏评估表格 (Somali)
- 食物过敏评估表格 (Spanish)
- 食物过敏评估表格 (Vietnamese)
Severe Allergy/Anaphylaxis Medication Order and Health History
- Severe Allergy/Anaphylaxis Medication Order and Health History (Amharic)
- Severe Allergy/Anaphylaxis Medication Order and Health History (English)
- Severe Allergy/Anaphylaxis Medication Order and Health History (Simplified Chinese)
- Severe Allergy/Anaphylaxis Medication Order and Health History (Somali)
- Severe Allergy/Anaphylaxis Medication Order and Health History (Spanish)
- Severe Allergy/Anaphylaxis Medication Order and Health History (Vietnamese)
患有哮喘的学生
学校哮喘评估表
- 学校哮喘评估表 (Amharic)
- 学校哮喘评估表 (English)
- 学校哮喘评估表 (Simplified Chinese)
- 学校哮喘评估表 (Somali)
- 学校哮喘评估表 (Spanish)
- 学校哮喘评估表 (Vietnamese)
Asthma Medication Order and Health History
- Asthma Medication Order and Health History (Amharic)
- Asthma Medication Order and Health History (English)
- Asthma Medication Order and Health History (Simplified Chinese)
- Asthma Medication Order and Health History (Somali)
- Asthma Medication Order and Health History (Spanish)
- Asthma Medication Order and Health History Vietnamese)
糖尿病学生
糖尿病评估表格
- 糖尿病评估表格 (Amharic)
- 糖尿病评估表格 (English)
- 糖尿病评估表格 (Simplified Chinese)
- 糖尿病评估表格(索马里语)
- 糖尿病评估表格 (Spanish)
- 糖尿病评估表格 (Vietnamese)
癫痫学生
癫痫发作评估清单
- 癫痫发作评估清单 (Amharic)
- 癫痫发作评估清单 (English)
- 癫痫发作评估清单 (Simplified Chinese)
- 癫痫发作评估清单 (Somali)
- 癫痫发作评估清单 (Spanish)
- 癫痫发作评估清单 (Vietnamese)
Authorization for Medications Taken at School
- Authorization for Medications Taken at School (Amharic)
- Authorization for Medications Taken at School (English)
- Authorization for Medications Taken at School (Oromo)
- Authorization for Medications Taken at School (Simplified Chinese)
- Authorization for Medications Taken at School (Somali)
- Authorization for Medications Taken at School (Spanish)
- Authorization for Medications Taken at School (Vietnamese)
Authorization for Treatments and Procedures Performed at School
Gives permission for an authorized person to assist a student by performing a specific treatment or procedure.
- Authorization for Treatments and Procedures Performed at School (Amharic)
- Authorization for Treatments and Procedures Performed at School (English)
- Authorization for Treatments and Procedures Performed at School (Oromo)
- Authorization for Treatments and Procedures Performed at School (Simplified Chinese)
- Authorization for Treatments and Procedures Performed at School (Spanish)
- Authorization for Treatments and Procedures Performed at School (Tagalog)
- Authorization for Treatments and Procedures Performed at School (Tigrigna)
- Authorization for Treatments and Procedures Performed at School (Vietnamese)
Diet Prescription for Meals at School
Updated process (as of March 16, 2023):
Please contact your school nurse if your student has a food allergy or medical condition that requires food accommodations at school. School nurse will provide you with a prescription dietary form. Once signed and completed by parent/guardian and healthcare provider, return form to school nurse. School nurse will then provide the completed dietary prescription form to Culinary Services to process.
The form must be completed by a Licensed Physician when identifying a disability, or a Recognized Medical Authority (RMA) when identifying a non-disabling medical condition. 饮食处方, a RMA includes a Licensed Physician, 骨科医生, 执业医师助理, ARNP or Licensed Naturopathic Physician.
非凡的护理支持
Field Trip/Outdoor Education Information and Release
Field trips are an educationally sound and important component in the instructional and/or athletic programs of schools.
Your student’s teacher and school nurse will partner and communicate with you about required authorization and health forms.
家庭/医院指令
- 家庭/医院指导- is a state (OSPI) program that provides funding for schools to provide limited scholastic support to students with a health issue. 资格, students must be expected to miss at least four (4) weeks of school, but no more than eighteen (18) weeks. In case of chronic illness, the services can be intermittent (Please indicate this on the application form). The form must be signed by the parent/guardian and the health care provider.
- Pregnancy and Postpartum – the “usual and customary” weeks of postpartum service are six (6) for a routine vaginal delivery and eight (8) for a c-section. Please do not exceed those numbers without indicating a reason the student is unable to attend classes because of 她自己的 医疗需求.
- Please note that 卫生服务 merely verifies the student’s eligibility for services and serves as a pass through for funding from OSPI. The school is responsible for finding a tutor and setting up the educational plan.
- There are strict requirements for reimbursement from OSPI for this funding so if/when the request is approved, please read the instructions carefully as we cannot fund services until H/H is approved. Buildings will be responsible for any expenses incurred beyond the limits of the program.
- 特殊教育学生 – 重要的是: If a student cannot attend school because of a need related to his/her qualifying special education condition, do not submit a Home/Hospital application until after contacting the school’s Section 504 coordinator and the IEP responsible staff for that student. Special Education manages funding for IDEA students who require Home Hospital support.
- 的指导方针
- Home/Hospital Application (English)
- Home/Hospital Application (Spanish)
- 指示表
免疫接种
发放医疗纪录(相互交流)
Gives 十大正规网赌软件 and a health care provider, 医院, or clinic permission to exchange information about a student.
*UW/Harborview requires authorizations in English
- 发放医疗纪录(Amharic)
- 发放医疗纪录(English)
- 发放医疗纪录(Simplified Chinese)
- 发放医疗纪录(Somali)
- 发放医疗纪录(Spanish)
- 发放医疗纪录(Vietnamese)
性健康教育
Transportation for Medical Reasons
For students who are within the walk zone but who have a medical condition that makes transportation necessary. May be for short-term or long-term conditions.
Application must be renewed annually.
Cannot be used to serve special education students for conditions related to their qualifying condition. Contact Special Education in those cases.