Nurse's Corner

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​​​​Welcome to the Haven Clinic​

Parents: If you have a child (ren) that requires medication to be given at school (complete the Medical Authorization), has health conditions or allergies please see the below forms. Please take time to review, print and obtain signatures if one of these applies to your child (ren) and return to the nurse. Thank you!​​

​Clinic Forms:

Asthma Action Plan

-Asthma Action Plan 10.1.20.pdf

Authorization for Self Administration of Medicine

-AuthorizationForSelfAdmin Asthma Med Epi Pen[16572].pdf

Diabetes Medical Management Plan​

-Diabetes medical management plan[16579].pdf

Dietary Prescription Plan

-Dietary Prescription Form[16578].pdf

Food Allergy Action Plan

-Food Allergy Action Plan 10.1.20.pdf

Authorization to Give Medication at School

-Medical Authorization2ARevised (1)[16577].pdf

Seizure Action Plan


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