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Health Services               Nurses: Download forms for your school Nurses' Packet of Forms Examination and Health History Forms Health Examination for Activities Physical Examination for School Entry Student Health History Form Medication Related Forms Authorization for Self-Carry of Medication Long Term Request for Prescription Medication Request for Short Term Prescription Medication Short Term Medication Request for Out of District Travel (Secondary students) Short Term Medication Request for Out of District Travel (Elementary students) Long Term Non-Prescription (OTC) Medication Request Care & Action Plans Allergy/Anaphylaxis Action Plan, Employee Allergy/Anaphylaxis Action Plan, Student Asthma Action Plan Diabetes Care Plan Diabetes Care Plan with Pump Emergencey Bus Plan Medical Statement to Request Special Meals or Accommodations Non-Medical Emergency Plan Seizure Action Plan Release Forms Consent for Release of Health Information Consent for Release of Education Records DHSS Authorization for Release of Immunization/TB Records Sample letter to parent of student found with bedbug Sample letter to parent of student whose classroom has bedbug Protocol if bedbugs are found on students or in the classroom Other Forms Medication Tracking Chart Parent/Guardian Request for Special Nursing Service Physician Authorization for Special Nursing Service Referral to Lions Joint Sight Committee		Health Services Menu Health Services Home About Health Services First Aid Health Forms Immunizations Links

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Anchorage School District 5530 E Northern Lights Blvd Anchorage, Alaska 99504-3135 907-742-4000