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Medication Order Forms
All medications to be given at school, prescription and non-prescription, require a medication order filled out and signed by a licensed healthcare provider AND signed by student's parent/guardian.

Medication to be taken at school

(prescription or non-prescription medication)


Severe Allergies/Anaphylaxis

Orders for Self-administration of Medications at School

Self-administration orders can be used for students who are capable of carrying and administering their own medications at school.  This includes inhalers, EpiPens, Benadryl, etc. All Self Administration orders must be signed by licensed healthcare provider, student's parent/guardian and MUST be checked and cleared with the school nurse before student may carry them at school

Please reach out to Nurse Press at or 818-709-7100 should you need specialty protocol orders for Diabetes, Seizures, Gastrostomy tubes, Nebulizer treatments, adrenal insufficiency, etc

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