Medical Forms
Find the forms that will keep your scholars healthy throughout the year. If you would like to speak to the nurses directly, you may do so by emailing Amy.Casey@greatheartstxschools.org.
Prescription Medications
If your scholar requires any prescription medications that must be administered during the day, please fill out the Prescription Medication Form.
PRESCRIPTION MED FORM
Asthma
If your scholar has a diagnosis of asthma requiring the using of an inhaler/nebulizer please fill out the Prescription Med Form (linked above) and the Asthma Action Plan.
ASTHMA ACTION PLAN
Asthma-Self Carry
If your scholar is 4th grade or older, your doctor may sign the Asthma Self Carry form if you would like them to carry their own inhaler at school.
ASTHMA SELF CARRY
Food / Environmental Allergy
Scholars with a diagnosis of a food/environmental allergy that requires an Epi-pen/Auvi-Q/Benadryl to be kept at school in case of an exposure will need 3 forms.
1. Food Allergy and Anaphylaxis EAP,
2. Prescription Med Form (linked above),
3. Food Allergy and Anaphylaxis Health History Form (linked in the section below)
Food / Environmental Allergy Continued
Scholars with a diagnosis of a food/environmental allergy that requires an Epi-pen/Auvi-Q/Benadryl to be kept at school in case of an exposure will need 3 forms.
1. Food Allergy and Anaphylaxis EAP (linked above)
2. Prescription Med Form (linked above),
3. Food Allergy and Anaphylaxis Health History Form
Food Allergy / Dietary Need
Scholars with a food allergy or a special dietary need must fill out the Great Hearts Texas Meal Accommodation Form, linked below.
This is the only way to communicate special dietary needs to the company that distributes the food to scholars in the MPR.
Meal Accommodation Form
As Needed Over-the-Counter Medication
Scholars that will need an "as needed" over-the-counter medication to be given at school for known conditions such as frequent headaches, pain/discomfort related to orthodontic work, GI related issues, etc. must fill out the Over-The-Counter Form, linked below.
Please note: The clinic does NOT keep Tylenol, ibuprofen, Benadryl, cough drops or any other over-the-counter medications for scholars at school. OTC medicines must be provided by the guardian with the appropriate paperwork.
OTC Medication Form