Adlai E. Stevenson School
Winston S. Churchill School
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» Nurse's Information
» Health Forms
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» COVID-19 Information
Health Forms
COVID-19 Clearance to Return to School (pdf)
Medication Permission Form (pdf)
Asthma Forms
Asthma Treatment Plan (pdf)
Physician's Certification for Self-Medication Form (pdf)
Diabetes Forms
Diabetes Medical Management Plan (DMMP) (pdf)
Diabetes Supply List (pdf)
Food Allergy Forms
Food Allergy and Anaphylaxis Emergency Care Plan (pdf)
Individual Health Care Plan
Individual Health Care Plan (pdf)
Head Injury Letter (pdf)
Seizure Forms
Seizure Action Plan (pdf)
Health Physical Form (pdf)
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