Complete this form if you are requesting an exemption to the immunization law for religious, medical or personal reasons.  Please return the completed form to the site.  The district nurse will submit the form to the Oklahoma State Department of Health Immunization Service. 

 

Complete this form if your child requires medication to be given at school, both prescription and non-prescription. District staff will not administer herbal or homeopathic mediation at school if it is not FDA approved. 

 

If your child needs to have an inhaler at school, please provide a Asthma Action plan to the site.  This form must be signed by your Physician.  

 

If your child has needs to have an Epi-Pen at school, please provide an Allergy Action plan to the site.  This form must be signed by your Physician.  

 

If your child is being treated for a seizure disorder, please provide a Seizure Action Plan to the site.  This form must be signed by your Physician.