Health Services Forms

Paper copies of the forms are also available at schools.  Completed forms should be turned in at your child's school.  

Release of Information Form

Allergy Forms

Non Life Threatening Allergy Form
Life Threatening Allergy Form
School Intake Form- Life Threatening Allergies

Asthma Forms

Asthma Action Plan

Bed Bugs Forms

Paperwork and Supply Requirements for Insulin Dependent Diabetics in MCCSC Health Offices
Students Using Insulin Injections
Students Using Insulin Pumps
School Intake Interview- Diabetes
Volunteer Health Aide for Diabetic Students

Medication Administration Forms

Medication Authorization Form
Procedure Treatment Form
Student Guidelines for Medication Administration
Student Use of Medications

Seizures

Seizure Action Plan

Vaccine Forms

Required Vaccines 2021-2022
Statement of Religious Objection
Indiana Code Regarding Immunizations