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Student Health Services » Health Forms

Health Forms

Health Form Links
 
Concussion Forms
Concussion Signs and Symptoms Checklist (English)
Concussion Signs and Symptoms Checklist (Spanish)
Parent Notification of Head Injury (English)
Parent Notification of Head Injury (Spanish)
 
General Medications
School Medication Authorization Form
Medication Administration Log
 
Allergies
Allergy and Anaphylaxis Emergency Action Plan
 
Asthma
Asthma Action Plan (English)
 
Diabetes
Diabetes Medication Management Orders
Diabetes Emergency Action Plan
Utah Diabetes Individualized Health Plan
Continuous Glucose Monitoring Addendum
 
Seizure
Seizure Individual Health Plan/Emergency Action Plan
Seizure Medication Management Orders
 
Vision
Vision Symptoms Questionnaire
Vision Screening Training Module for volunteers