Special Health Conditions/Medications/Diet
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Student Information Release Authorization Form
Allows Bremerton School District and a health care provider, hospital, or clinic to exchange information about a student.
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Diet Prescription for School Meals Form
Required for students with dietary prescriptions or restrictions, food allergies or intolerances, or other specific dietary needs.
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Medication Authorization Form
Required for students who need medication during the school day.
Special Diet & Medication Information
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If your child has a dietary prescription, restriction, food allergies or intolerances, or specific dietary needs, please complete the Diet Prescription for School Meals form with a health care provider. The provider’s order can be attached to the form or faxed to the school instead of filling out their section. Please return the completed form to your child’s school nurse or designated school employee.
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If your child requires medication during the school day, please complete the Medical Authorization form with a health care provider. The provider’s order can be attached to the form or faxed to the school instead of filling out their section. Return the completed form to your child’s school nurse or designated school employee.
Important Guidelines:
- Annual Renewal: Medication orders must be for the current school year and renewed annually.
- Self-Carry Medication: If a student needs to self-carry their medication the Medical Authorization form must indicate that the student can self-administer. The student must demonstrate to the school nurse that they can correctly administer their medication.
Examples of Medications:
- As-needed medications, such as an EpiPen or Albuterol.
- Over-the-counter medications, like Tylenol or hydrocortisone cream.
Medication Requirements:
- All medications must be in the original labeled container with the student’s name, medication name, dosage, and type of administration.
- Medication must be dropped off by a parent/guardian and be counted with a school nurse or designated school employee before being accepted by the school.
If these requirements are not met, the parent/guardian must come to the school to administer the medication.
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If your child needs treatment at school, such as G-tube feeding, suctioning, insulin calculations, and urinary catheterization, please contact their school nurse.