Please complete the form below. Required fields marked with an asterisk *

Please use this page to upload your child's specific emergency action plan. 

Ex. Illinois Food Allergy Emergency Action Plan and Treatment Authorization, Asthma Action Plan, Diabetes Management Plan or other. 

• Please be sure that all forms are completed before submitting them to the school. This includes:
  • The student’s name, date of birth, and grade level clearly indicated.
• All medications to be administered are documented (if a medication is not indicated, it cannot be administered) on the form.
• Medication(s) name, dose and time to be administered should be clearly indicated. 
• All forms must be completed and signed by the parent and physician for them to be valid.