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Health Forms

 
Medication Permit
 
MPUSD is not currently authorized to stock any medications on campus. If your child requires medications for their health condition (including inhalers, allergy medications such as EpiPens, or insulin) it must be provided to the school with the appropriate paperwork. 

While schools do have stock first aid supplies, there is no stock available for specialized procedures. If your student requires supplies for procedures such as blood glucose checks, gastric tube feedings, or catheterizations, supplies must be provided to the school. 
 
Medications cannot be stored on your child's school campus over the summer recess. All medications must be picked up by an adult at the end of the school year. The district will make every effort to remind families to pick up their medications, however, any medications that are not picked up by a parent or guardian at the end of the school year will be disposed of.
 
Please refer to the Parent/Guardian and Student Handbook or MPUSD's Board Policies page for more information about our health and medication policies.
Allergy Action Plan
 
If your student has a severe allergy please have their doctor fill out the Allergy Action Plan below. A Medication Permit will be required for each medication needed on campus (i.e. one for Benadryl, one for EpiPen). MPUSD is not currently authorized to stock EpiPen and EpiPen Jr.
Asthma Action Plan 
 
If your student has asthma please have their doctor fill out the Asthma Action Plan below. A Medication Permit will be required for each medication needed on campus. MPUSD recommends that all students with asthma have an inhaler on campus in case of an emergency. Inhalers can be carried by students and self-administered if signed off by a doctor.
Diabetes Management Plan
 
If your student has diabetes please have their doctor fill out the Diabetes Management Plan below, or provide your student’s school with a copy of the plan generated by your student’s doctor’s office. School staff are happy to assist your student with the management of their diabetes while at school. If your child manages their diabetes independently please have this indicated by the doctor on their Diabetes Management Plan. A Medication Permit will be required for each medication needed on campus (i.e. one for insulin, one for glucagon).
Seizure Action Plan
 
If your student has a seizure disorder please have their doctor fill out the Seizure Action Plan below. A Medication Permit will be required for each medication needed on campus.