Medical Forms

These health forms will allow the Austin ISD Health Services team to provide care for your student while at school.

(Select a topic to expand)

Request to Administer Medication

Only medications that are necessary for a student’s medical care will be administered at school. Most medicines that are needed, even up to three times a day, can be given at home and should not be sent to school.

There are some occasions where medication is required by students and cannot be adequately given at home. In these cases, with written permission of a parent or guardian, designated care staff can give the medication.

A physician's signature is required for all medications that will be given at school to include the following:

If your student requires medication at school, please complete the form:

Only a parent or guardian may drop off and pick up medication at the nurse’s office. Students are not allowed to carry medication with them in school or on the bus. Unused medication will be discarded after 30 days.

Medication must be in its original container. The school nurse will not accept or administer any medications that are in Ziploc bags or improperly labeled bottles. No mixtures of medication are accepted (i.e. Tylenol 500 mg and 250 mg in one container). Please make sure the medication has not reached the expiration date on the bottle.

Please make arrangements so the medication can be left at the nurse’s office until the last day the medication is to be given. If the pharmacist is unable to prepare a separate container for home and school, keep enough medication for home use and bring the rest to the school in the original prescription bottle.

If non-prescription medications are required longer than one week, have the physician write an order to keep in the nurse’s records.

Students with prescription asthma or anaphylaxis medication may possess and self-administer their medication following rule 38.15 of the Texas Education Code. This will require written permission from their doctor stating that the student may self-administer. It will be kept on file in the nurse’s office and is valid for the current school year only.

If your child wears contact lenses, she/he should keep a case and small solution bottle in her/his locker or backpack. Using their own supplies reduces the risk of eye infections.

Food Allergy and Anaphylaxis Plan

For students with anaphylaxis to food, insects, or other substances, please use one

Guidelines for the Care of Students With Food Allergies At-Risk for Anaphylaxis

Austin ISD’s Food Allergy and Anaphylaxis Emergency Care Plan was developed to care for students with a diagnosed or undiagnosed potentially life-threatening allergy at risk for anaphylaxis, a life-threatening allergy response.

Anaphylaxis is a serious immune-mediated response that develops after ingesting or coming in contact with allergens such as foods, insect stings, latex, or medications. Anaphylaxis may occur within minutes and up to 2 hours after exposure to an allergen.

This Emergency Care Plan is in compliance with Texas S.B 27 and 66 as outlined by the Texas Department of State Health Services Allergies and Anaphylaxis Guidelines.

Austin ISD will follow an individualized health plan (IHP) for students with food allergies upon receipt of signed medical plans and parental consent forms.

The IHP involves cooperation and communication between students, parents, student’s physician, school nurse, counselor, food services, and other Austin ISD personnel as needed: