Medication Forms
Students who require medication to be used during school hours (e.g. asthma inhaler, Epi-Pens) need LAUSD medication forms to be completed by their primary care provider. Below are forms to download and print. After completion by a California-licensed doctor, parents need to also sign the forms and provide the completed forms with the medication to the school nurse. Medication forms can also be picked up from the main office.
ASTHMA FORMS - Print and provide the following two pdf files to your child's primary care provider to complete. Parent needs to also sign both forms. Provide completed forms and medication to school nurse.
EPI-PEN FORMS - Print and provide all four of the following pdf files to your child's primary care provider to complete. If the allergy is not a food allergy, then you can disregard the Special Diet Form. Parent needs to also sign the forms. Provide completed forms and medication to school nurse.