Health Care Plans & Forms
RCW 28A.210 requires that students with life-threatening conditions must have physician orders and a health care plan before attending school. This information may be shared with school district staff that have a "need to know," in order to provide a healthy, safe environment.
Click a link below to view or download a file.
- Request For Dietary Accommodations
- HS-112 Activity Restrictions
- HS-210A Authorization for Release of Information
- HS-210 Authorization for Exchange of Information
- HS-300A Medication Request Form
- HS-300B Self Carry Medication Request Form
- HS-550 Asthma Info Form
- HS-555 Asthma Health Care Plan
- HS-598 Concussion Pilot Form
- HS-630 Allergy Information
- HS-634 Severe Anaphylaxis Care Plan and Medication Orders
- HS-713 Seizure Combined Health Care Plan
- HS-714 Seizure VNS orders
Athletics & Activities
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PHYSICAL EXAMINATION FORM
The recommended physical examination form – STAYS WITH YOUR DOCTOR -
MEDICAL ELIGIBILITY FORM
The recommended medical clearance form – GIVE TO YOUR SCHOOL