Policy 6200: Health Requirements & Services: Medical Treatment

Asthma

Asthma Action Plan

Allergy & Anaphylaxis

Allergy & Anaphylaxis Individualized Healthcare Plan (EAP)/Medication Authorization Form
Food Allergy & Anaphylaxis Emergency Care Plan
EpiPen Form

Chickenpox

Chickenpox Fact Sheet
Chickenpox Medical Plan
Chickenpox Report Form

Concussions

Concussion Check List
Concussion Policy & Forms

Diabetes

Diabetes Emergency Care Plan
Diabetes Continuous Glucose Monitor (CGM) Addendum to IHP
Diabetes Individual Healthcare Plan ADA
Diabetes Insulin Injection Addendum to IHP
Diabetes Insulin Pump/Smart Pen addendum to IHP
Diabetes Medication/Management Orders

Dietary Needs

Dietary – Special Diet Requests

Medications

Medication Authorization Form
Medication Administration Log

Seizures

First Aid for Seizures
Seizure Individualized Healthcare Plan/Emergency Action Plan
Seizure Medication/Management Orders

Tuberculosis Screening

Tuberculosis Enrollment Form

Utah State Immunization Information System (USIIS)

USIIS Permission Form