Ehrhardt Clinic
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Medication Form
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If your child needs to take medication at school please fill out this form. Remember the new policy is NO medication can be brought to school by the student!

Seizure Action Plan Form
Seizure Action Plan Form

If your child has seizures please fill out this form, Have doctor sign and bring to school nurse along with any medications required at school.

Seizure Action Plan

Allergy Action Plan Forms for parent and doctor to fill out sign and return to school nurse:

Allergy Action Plan


Permission to carry an Epi Pen Form:


Permission Form to Carry Epi Pen


Milk Substitute Form:
Milk Substitute Form
Asthma Action Plan
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Asthma Action Plan
If your child has Asthma and will need an inhaler or nebulizer treatment at school Please fill out Doctor signs  and bring to school with medication.

Asthma Action Plan


Self Carry Considerations Unless an additional supply of medication is provided for storage in the school nurse’s office, parents and students must recognize that it is the student’s responsibility to carry the medication at all times. The school does not keep an emergency supply of asthma medication in stock. Students who require asthma medication for athletic activities must also process the medication through the school nurse. If the student has permission from the physician on the Asthma Action Plan to self carry their asthma medication, they may do so after discussion with the school nurse. If they do not have authorization to self carry the medication, the school nurse will coordinate with the athletic coach to make sure that the students’ medication needs are met.

Permission form to carry inhaler:
Permission to Carry Epi Pen Forn
Diabetic Action Plan
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Diabetic Action Plan

If your child is diabetic the following forms must be filled out and signed by your doctor and returned to school.
Along with all testing supplies, emergency meds, snacks, insulin and syringes.

http://classroom.kleinisd.net/users/0925/diabetic%20plan0001.pdf