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Forms
Back to School Help Fair Flyer:
Back to School HELP Fair 2024 Flyer4.25.24
Physical Form:
Child Health Exam Form Revised 01 31 2024 (1)
SPORTS PHYSICAL FORM (This can’t be used for the school physical)
Dental Forms:
Dental Exam Form 2021 Editsspanish Final
Dental Exam Waiver 2021 Editsspanish Final
Kindergarten Round up forms:
Kindergarten Round up Flyer 2024
Meningococcal Form:
Wellness Express Forms:
SIU Consent Required For All Physicals
Allergy Policy and Forms:
Guideline For Management Of Children With Life Threatening Allergies Revised 2019
Allergy Medical Management Plan (Action plan plus orders)
Physician Statement For Food Substitution
Girls Talk Outline:
Asthma Forms:
Asthma Medical Management Plan (Action plan and orders)
Parental Authorization Request For Self Administration Of Asthma Inhaler
Seizure Forms:
Seizure Medical Management Plan (Action plan and orders.)
Diabetes:
DIABETES MEDICAL MANAGEMENT PLAN
Informational Forms on Diabetes: (If your child has warning signs, please talk to your Provider. If your child gets diagnosed, please follow up for a treatment plan)
English-understandingtype1diabetes
English-NDM24-English_Flyer_FINAL
Spanish-NDM24-Spanish-Flyer-Design_FINAL
Medication Forms:
Authorization and Permission for Administration of Medication 2023
AUTHORIZATION AND PERMISSION FOR SPECIALIZED MEDICAL TREATMENT
(For Seizure, asthma, diabetes, and allergy orders, please refer to those sections located above.)
Diabetes:
DIABETES MEDICAL MANAGEMENT PLAN
Eye Exam Forms:
Other Forms:
Adams County Health Department
Facts about Meningococcal Disease
