Health Forms

All forms should be completed and emailed to the main office info@adelinemontessori.com. 

1. Health History Form – All students.
2. Child Health Report – All students under age 5.
   • All students under age 2 need to have this form updated every 6 months.
   • Students over age 2 but under age 5 need this form completed every 2 years.
3. Immunization Form – Must include a copy of the immunization records.
   • Infant -5K
   • 1st Grade – Secondary
4. Medication Authorization – Any child who will need to take medication while at school. 
5. Asthma Action Plan – Any child who suffers from asthma. 
6. Anaphylaxis/EpiPen – Any child who has an Epi-Pen.
   • Two Epi-Pens must also be sent to school; one will be stored in your child’s classroom and the other in the office. 
7. Diabetes Management Plan – Any child who has been diagnosed with diabetes. 
8. Seizure Action Plan – Any child who has been diagnosed with a seizure disorder.