266 East Main Street • Ramsey, NJ 07446

 Medical Concerns and Medication Authorization Forms 
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  • Medication Authorization for Asthma

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    Print and complete this form and return it to your school nurse if your child requires any medication for asthma. 
    Asthma Action Plan.pdf 203.94 KB (Last Modified on June 2, 2015)
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  • Medication Authorization for Food Allergies

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    This fillable form is used for students that may require the use of an EPI-PEN, AUVI-Q, or Benedryl during the school day. 
    EPI-Pen updated 6-13.pdf 371.82 KB (Last Modified on June 26, 2013)
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  • Medication Authorization for Daily & As Needed Medications

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    This fillable form is used for prescription and non-prescription medications, both daily and "as needed".
    Medication Authorization Form 2014.pdf 68.71 KB (Last Modified on December 16, 2014)
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  • Medication Self Administration Form - Dater/Smith/RHS ONLY

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    This fillable form may only be used for students that have express permission from their physician and have been trained to administer their medication, such as an Epi-Pen. Students in Tisdale and Hubbard Schools are never permitted to self-administer medication.

    Self Medication Request form.pdf 108.78 KB (Last Modified on December 16, 2014)
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  • Diabetes Management Form

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    Print and complete this fillable form and return it to your school nurse if your child has a diabetic condition. 
    Diabetes Management for RT.pdf 653.21 KB (Last Modified on January 14, 2014)
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