Student Health Forms

NC Immunization Schedule

• Required School Immunizations

Health Assessments

• Health Assessment Transmittal Form
  required for kindergarten and new to NC entry

Health Forms for Providers

Dietary

• Medical Statement - Diet Order (English)
• Medical Statement - Diet Order (Spanish)

Emergency Action Plans
provider signature required

• Allergy
• Asthma
• Asthma (non self carry)
• Diabetes Medical Management Plan
• Seizure
• Seizure (intranasal midazolam administration)
• Heart, Ortho, or Other

Medications

• Medication Record 2019-20 (English)
• Medication Record 2019-20 (Spanish)
• Medication Record 2019-20 (Russian)
• Self-Medicating Order Form (English)
• Self-Medicating Order Form (Spanish)

Sports Physicals

• Sport PreParticipation Examination Form (English)
• Sport PreParticipation Examination Form (Spanish)

Parent Information

• Asheville City Schools Policies
• Buncombe County Schools Policies
• ​Fluid Milk Substitution Form
• Prescription Pill Addiction
• Risks for Addiction in Student Athletes
• Safely Treating Athletic Injuries

Individual Health Plans

• Allergy (English)
• Allergy (Russian)
• Allergy (Spanish)
• Asthma (English)
• Asthma (Spanish)
• Diabetic Type II
• Heart, Ortho, Other
• Hemophilia
• Other (Spanish)
• Seizure (English)
• Seizure (Spanish)
• Sickle Cell
• Health Assessment Transmittal Form