Health Forms

Release of Student Information - Allows exchange of information with Buncombe County Schools related to student's health and/or educational planning.

Allergy Emergency Action Plan - Provides emergency instructions in case of a severe allergy.

Asthma Emergency Action Plan - Provides information regarding the student's asthma symptoms and emergency needs.

English 

Spanish 

Russian 

Moldovan 

Athletes NCHSAA Physical Form - Completed each year for student athletes.

Diabetes Action Plan - Provides information regarding the student's diabetes management and emergency needs. 

English

Spanish

Moldovan 

Dietary Needs Form - Completed in case of special nutritional needs for school meals.  A medical statement from the student's physician is required.

Medical Statement Required

Medical Statement Required - Spanish 

Medication Logs - Used to record daily medications given at school.

Medication Log - page 1   (Physician completes initially, then maintained by school staff)

Medication Log - page 2   (Parent completes)

Spanish

Russian

Moldovan 

Seizure Emergency Action Plan- Provides emergency instructions for students who have a history of seizures.

English

Spanish 

Russian

Moldovan 

Self Medicating Agreement - Allows students to administer medication to themselves.

English

Spanish 

Russian

Moldovan 

Sickle Cell Emergency Action Plan - Provides information for students who have Sickle Cell Disease.

English 

Moldovan