Forms

Action Plans and Medication Forms

Allergy- Please fill BOTH forms out if your student will self-carry an Auvi-Q, Epi-Pen, etc.

• Life-Threatening Allergy Action Plan.pdf (madison-schools.com)
• AUTH TO CARRY.pdf (madison-schools.com)
• Medication Permission Form

Asthma- Please fill BOTH forms out if your student will self-carry a rescue inhaler.

• Asthma Action Plan.pdf (madison-schools.com)

• AUTH TO CARRY.pdf (madison-schools.com)

• Medication Permission Form

Diabetes

• DIABETES ACTION PLAN.pdf (madison-schools.com)
• Medication Permission Form

Seizure

• SEIZURE ACTION PLAN.pdf (madison-schools.com)
• Medication Permission Form

Medication- This form needs to be filled out by your student’s Doctor for ANY medication administered at school.

• MEDICATION PERMISSION REQUEST FORM.pdf (madison-schools.com)