Student Health Forms

All students need:

Health Inventory: STUDENT RECORD (marylandpublicschools.org)

Lead Testing Certificate: Maryland MDH Blood Lead Testing Certificate (marylandpublicschools.org)

Immunization Form: MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE IMMUNIZATION CERTIFICATE (marylandpublicschools.org)

Allergy, Asthma, Medication Forms

These forms need to be completed every 12 months.

Students diagnosed with Asthma will need the 3-page Asthma Action Plan and Medication Administration Authorization form (OCC 1216A) completed by their physician and brought to school along with the prescribed medication in its original box/container before attending class.

Students diagnosed with an Allergy and/or Anaphylaxis will need the 2-page Allergy and Anaphylaxis Medication Administration Authorization form (OCC 1216B) completed by their physician and brought to school accompanied by the prescribed medication in its original box/container before attending class.

For students who require other medication at school except those for Asthma, Allergy or Anaphylaxis conditions will need this 2-page Medication Administration Authorization form (OCC 1216) completed by their physician: https://earlychildhood.marylandpublicschools.org/system/files/filedepot/3/occ1216-medicationadministrationauthorization.pdf