Student Forms

Health Forms

Please return all health forms to the school nurse by our school nurse, Rachel Wells at rwells@athlosjp.org or by delivering them to the check-in table in the front office foyer.

Diet Prescription for Meals at School

A Diet Prescription for Meals at School form or a doctor’s order needs to be updated at the start of each school year. Verbal updates or phone calls cannot be accepted. If your child has a food allergy, please submit an updated doctor’s order to specify the food allergy as soon as possible. If there is a food preference, parents can write a letter to the school nurse/administration for inclusion in the student’s file.


Authorization to Administer Medication

Medication Order

You may arrange for medications to be dispensed by school nurse/trained staff. All medication (prescription and non-prescription) must be accompanied by a consent form and a physician’s medication order, which includes the date, the name of the medication, dosage, time to be given at school, route of administration, and any special instructions. Take the form to your child’s doctor and have him/her complete the form by listing the medication(s) needed, dosage, and number of times per day it is to be administered. Medication will not be administered without an order form from a Louisiana (or adjacent state) licensed physician, dentist or other prescriber authorized in the state of Louisiana.


Self-Medication Authorization Form

Some students may need to self-medicate for certain chronic health conditions. Students who need to self-medicate with a prescription drug (i.e. Inhaler, Epi-pen, oral prescription medications, etc.) must have a self-medication authorization form on file at school which includes the physician and parent/legal guardian signatures.

Students who may need to self-medicate with an over-the counter medication (non-prescription) must have a written authorization by their parent/legal guardian that includes the date, time medication is to be self-administered, and the amount to be taken. Medication should be in an original container and labeled. If students are seen giving or selling any medication to another student, they will be violation of the school drug policy.

Health Information