Medical Info

Medical Documents

Below are various medical documents that may apply to your student. Please print those that apply, fill them out and return them to the middle building front office so that we have them on file.

A. If your student has medications to be given at school, please complete and return these two forms:

  1. Parent/Guardian Authorization to Administer Medication at School
  2. Medication Guidelines for ALA

B. If your student needs to have a self-administered asthma medication, please complete and return these four forms:

  1. Parent/Guardian Authorization to Administer Medication at School
  2. Medication Guidelines for ALA
  3. Asthma Action Plan Checklist
  4. Asthma Medication Self-Administration Form

C. If your student needs to have an EPIPEN, please complete and return these three forms:

  1. Parent/Guardian Authorization to Administer Medication at School
  2. Medication Guidelines for ALA
  3. EpiPen Self-Administration Form

D. Diabetes Medications need to have these forms completed.

  1. Diabetes Healthcare Plan
  2. Glucagon Authorization

E. Additional Documents

  1. Immunization Requirements – this form covers the various required immunizations as well as the Utah state codes regarding immunizations and exemptions.