Forms

Below you will find a number of forms that you can use for enrollment and medication authorization.  The forms are in pdf format.

Enrollment Forms

Medication Forms

  • Over the Counter Skin Medication
    • (diaper cream, sunscreen, & bug spray) 
    • Valid for up to 1 year
  • Medication Authorization
    • OTC or Prescription
    • (in original container w/manufacturer instructions)
    • Valid for up to 2 weeks (without doctor signature)
    • Valid for up to 1 year (with doctor signature)
  • Health Plan
    • required for children with long term medications
    • required for children with special medical needs
    • requires doctor signature