School Health Forms

  • 2016 NC Health Assessment Transmittal Form

    This form is to be completed on each student and returned to the school nurse.

  • Student Health Form

    This form is to be completed on each student and returned to the school nurse.

  • WCPS Asthma Emergency Action Plan

    This care plan contains directions for what to do for a particular student with asthma. It is to be completed by the parent and returned to the school nurse.

  • WCPS Diabetes Care Plan

    This file contains the Diabetes Care Plan, that needs to be reviewed with the student's doctor and completed prior to the student attending school each year. *Note: Please also view and print Parent Responsibilities, and Insulin Pump (if applicable).

  • WCPS Insulin Pump

    This form will also need to be completed along with the Diabetes Care Plan if your child uses an insulin pump.

  • WCPS Parent Responsibilities

    This form contains a list of parent responsibilities for students with diabetes and will be reviewed with you by your school nurse.

  • Medication Letter to Parents

    This letter is a brief description of requirements for medication to be administered/allowed during school hours.

  • Medication Authorization Form

    Form that parents need to have completed each year prior to students being given/taking medicines at school. It requires both the parent and physician signatures.

  • Kindergarten Health Assessment/Immunization Law for school attendance

    This letter to parents contains information about NC law regarding Kindergarten Health Assessment and Immunizations required for school attendance.

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