PWCS Health Treatment Plans

Health Treatment Plans

Health treatment plans should be completed by the student's physician and delivered to the nurse at the start of each school year. Any accompanying medications must be delivered by the parent in original, unopened packaging with prescription label intact (when applicable) and unexpired. Students are not permitted to transport medications to and from school.

Virginia Asthma Action Plan

Updated Virginia Diabetes Medical Management Plan (DMMP)

Seizure Action Plan

Cancer Care Plan

Authorization for Medication Administration Form

Clean Intermittent Catheterization Treatment Plan

Tube Feeding Treatment Plan

Medical Procedure Treatment Plan

Food Allergy & Anaphylaxis Emergency Care Plan

Request for Administration of Medication for Allergic Reactions

Student Epinephrine Self-Carry Authorization

Severe Allergy Individual Health Care Plan

Student Allergy History Form

Authorization to Implement Health Treatment Plans
(Must accompany all PWCS Health Treatment Plans)

Release of Medical Information Authorization