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District

Health Forms

HEALTH HISTORY FORM

Upon initial enrollment and whenever there has been a change to the student's health history, complete the above form and submit it to the school office or nurse.

IMMUNIZATION HISTORY FORM

Below is a link to download a convenient form for recording immunizations needed for school enrollment.

MEDICATION PERMIT FORM

Please print and complete this form whenever medication will be administered to a student at school. This form must accompany the medications and be submitted to the school office or nurse.

NON-PRESCRIPTION MEDICATION FORM

For students in grades 9-12 only, Northwest Allen County Schools allows the school nurse to administer non-prescription medication one time per day and up to three times per semester if parental permission has been given. 

To grant permission, use the form linked above and send it to the school office. This will allow the school nurse to administer two ibuprofen once per day as needed, up to three times per semester. The form will remain on file for the current school year only. For additional medication after the limit has been reached, use the Medication Permit Form.