Health Forms

 Student Health Information & Physical Exam Form

 Student Immunization Record / Waiver Form (To be completed by Parent)

 Medical Excuse Form (To be completed by Physician)

 Physical Education/Recess Activity Excuse Form (To be completed by Physician)

Self Administration of Medication.pdf Asthma Management Form

Self Administration of Medication.pdf Food Allergy Health Plan (To be completed by Parent and Physician)

Self Administration of Medication.pdf Anaphylactic Allergy Health Plan (To be completed by Parent and Physician)



Medication Forms

In compliance with Wisconsin State Law, the Appleton Area School District has adopted a policy for the administration of medications. For school personnel to administer medication safely and efficiently, parents/guardians and/or adult students must comply with district policy.

Medications should be administered at home whenever possible. Parents/guardians are urged to consult with the prescribing practitioner to determine if medications can be scheduled outside school hours. In the event that this is not possible, designated district staff will administer medication according to district policy (453.4)

Medication forms may be obtained from the school office or below:  

Informational Letter to Parents.pdf Informational Letter to Parents (Important - Please Read!)

pdf (Hmong Version) Kev saib xyuas kev noj tshuaj hauv tsev kawm ntawv NIAM TXIV/TUS SAIB XYUAS COV NTAUB NTAWV

Medication Administration Form.pdf Medication Administration Form (To be completed by Parent and Physician)

pdf (Hmong Version) DAIM NTAWV TSO CAI RAU SIV LOS YOG NOJ TSHUAJ

Self Administration of Medication.pdf Self Administration of Medication (To be completed by Parent and Physician)

pdf (Hmong Version) DAIM NTAWV  TSO CAI RAU TUS KHEEJ ROV MUAB TSHUAJ RAU NWS TUS KHEEJ SIV LOS YOG NOJ NYOB RAU HAUV TSEV KAWM NTAWV

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