Forms

If your student has any significant health conditions including asthma, food allergies, diabetes or seizures, please complete the appropriate Information Form.

If your student requires any prescription medication while at school, page one of the Medication Permission Form must be completed AND signed by a doctor. Page two of this form is for non-prescription medications and may be completed by the parent or guardian.  

If your student will be carrying an inhaler or Epi-Pen in their backpack or locker, the Medication Self Administration Form must also be completed AND signed by a doctor. This form indicates your student has received training in when and how to administer the medication as well as alerts the nurse that medication is available if the student is too ill to self-administer.

Thank you for helping us take great care of your student!

Mill Creek Middle School Nurses

Natalie Shultz
Erica Catausan 

Allergy Information Form

Asthma Information Form

Diabetes Information Form

Seizure Information Form

Medication Permission Form

Medication Self Administration Form