
Pre-K-12
Forms
Allergies
Asthma
- Asthma Action Plan, Medication Authorization and Self-Administration (State Form)
- Asthma Action Plan, Medication Authorization and Self-Administration (Spanish)
- Asthma Medication Authorization & Inhaler Authorization Self-Administration Form
- Is the Asthma Action Plan Working? (Tool Kit, NIH)
- Steps to follow for an Asthma Episode in School
- Help Paying for Asthma Medicine
Diabetes
- Insulin Administration in School Setting (PCH)
- Diabetes Medication/Management Orders (DMMO, State Form)
- Diabetes Emergency Action Plan (State Form)
- Utah Diabetes Individualized Healthcare Plan
- CGM Addendum to IHP
American Diabetes Association (ADA)
Primary Children’s Hospital Guidelines
Medication
Seizures
- Seizure Action Plan
- Seizure Medication Management Order (SMMO)
- Guidelines for Seizures in Schools
- Volunteer Skills Checklist
- Volunteer Documentation Form
- STARR Poster
- Seizure First Aid Poster
- Volunteer Intranasal Presentation
- Intranasal Video
- Intranasal Post-Test
- Volunteer Rectal Medication
- Rectal Video
- Rectal Post-Test
- Sample Seizure Log
- Volunteer Training Certificate
- Training Stipend Form
Vision Screening Guidelines
- Annual Vision Report
- Sample Opt-Out Form
- School Vision Screening Guidlines
- Symptoms Questionnaire
- Vision Certificate
- Vision Referral and Report Form
- Vision Training Module A: Vision Screening Basics
- Module B: Training for Volunteers
- Module C: Tier 2 Vision Screening