Diabetic Protocol.docxStudents are not permitted to carry or dispense any kind of prescription or non-prescription drugs on campus or at a school related function. If a student must use medication, it must be brought to the clinic before the school day, in its original container, accompanied by a note from the parent/guardian stating they give permission for the student to take the drug, the dosage and the time(s) it is to be taken.
If the medication is necessary at a school related function, it must be presented to the sponsor at the beginning of the event, in its original container, accompanied by a note from the parent/guardian stating they give permission for the student to take the drug, the dosage and the time(s) it is to be taken. The school will verify all information with the student’s parent/ guardian.
Chronic illnesses must be updated by a doctor at the beginning of every school year.
Clinic General Forms:
Physician Ordered Procedures
2020-2021 Authorization for Medications
Medication Receipt / Pick-Up Record
Diet Order Form
Diabetes Forms:
2020-21 Diabetes Protocols
2020-2021 Authorization for Medications
Medication Receipt / Pick-Up Record
Diet Order Form
Diabetes Authorization for Self-Carry / Administration During School and School Sponsored Activities
Cystic Fibrosis Forms:
2020-2021 Authorization for Medications
Medication Receipt / Pick-Up Record
Authorization for Self-Carry / Administration of Prescribed Pancreatic Enzyme Supplements During School and School Sponsored Activities
Asthma Forms:
2020-21 Asthma Protocols
2020-2021 Authorization for Medications
Medication Receipt / Pick-Up Record
Authorization for Self-Carry / Administration of Metered Dose Inhalers During School and School Sponsored Activities
Anaphylaxis Forms:
2020-21 Anaphylaxis Protocols
2020-2021 Authorization for Medications
Medication Receipt / Pick-Up Record
Diet Order Form
Authorization for Self-Carry / Administration of Epinephrine Auto-Injector During School and School Sponsored Activities
Clinic Contact Information:
Dorilee Diaz, RN
[email protected]
407-816-5600 ext. 6082343
Marie Joseph, LPN
[email protected]
407-816-5600 ext. 6082307