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Health Services Forms
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| Listed below are a number of forms that are used by the Manheim Central nurses. Please feel free to print and complete any of these forms at home. |
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| Emergency Information: This form is used to provide emergency contact information for your child. |
| MCSD Medication Authorization: This form is used to give the school permission to administer a medication that is prescribed by a licensed physician. |
| Asthma Action Plan: This form provides the nursing staff with specific guidelines to manage your child's asthma. |
| Emergency Health Plan: This form provides the nursing staff with specific guidelines to manage your child's severe allergy. |
| Physical Form: Physical exams are required upon original entry to school, sixth grade, and eleventh grade. |
| Dental Form: Dental exams are required upon original entry to school, third grade, and seventh grade. |
| Seizure Action Plan: This form provides the nursing staff with specific guidelines to assist your child with seizure monitoring and treatment. |
| Free Immunizations: This form provides information on free immunizations for children with no medical insurance or those who are enrolled in Medical Assistance. |
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