Forms

Please find enclosed, common forms that you may find useful in communications with the school nurses of Penn Manor School District.

Annual Health Profile

Physical exam form

Medication Administration Consent and Licensed Prescriber Order Form

Release of Information Form

Private Dentist Form

Allergy Action Plan

Doctor’s Permission for Treatment for Asthma

Doctor’s Permission for Treatment for Diabetes

Doctor’s Permission for Treatment for Milk or Food Substitution

Seizure Action Plan

Vaccination Documentation Form





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