Health Information / Medication Forms

Greetings from your School Nurses!

We are excited to welcome your student and family to the Moses Lake High School. Please use the following links to update your student's Health Information and for medication at school. You will see a brief explanation of each below the link. Paperwork can be turned in at the Moses Lake High School or sent directly to the school nurse.

Liz Pray MSN-Ed, RN, NCSN Cindy Welsh BSN, RN

[email protected] [email protected]

Secure Fax 509-793-7505 Secure Fax 509-793-7511

Health Information Forms - after opening the link please click Fill a Copy at the top right corner and agree to do this form electronically.

Health Information Form, English

This form should be completed annually for your student. It is used by the school nurses to create health plans, ensure that teachers are trained to support your student if there are health concerns, and or provide information to EMS in the event of an emergency.

Health Information Form, Spanish

Este formulario debe completarse anualmente para su estudiante. Las enfermeras escolares lo utilizan para crear planes de salud, asegurarse de que los maestros estén capacitados para apoyar a su estudiante si hay problemas de salud o proporcionar información a EMS en caso de una emergencia.

Medication Forms

Please use the following forms to take to your physician if your student has Asthma, Allergies, or will need other Prescription Medication during the school year.

Asthma Orders

Asthma Orders, Spanish

Allergy Orders

Allergy Orders, Spanish

Prescription Medication Order

Prescription Medication Order, Spanish

**ALL FORMS ARE REQUIRED TO BE FILLED OUT PRIOR TO YOUR STUDENT STARTING SCHOOL AND OR THE START OF EVERY SCHOOL YEAR. Please do not wait until August to get these forms completed. All other health plans will be sent home with your student the first couple weeks of the new school year. If you get a health plan from your student, please review and sign then return to the school nurse.

Other Forms

Non-Prescription Medication Form

This form is used for students who self-carry medication that is Over The Counter or Non-Prescription strength. Your student is required to have this form on file with the health room if they have any type of medication in their backpack. Examples would include Tylenol, Ibuprofen, Tums, Midol, etc.

Non-Prescription Medication Form, Spanish

Este formulario se utiliza para los estudiantes que llevan consigo medicamentos de venta libre o sin receta. Se requiere que su estudiante tenga este formulario archivado en la sala de salud si tiene algún tipo de medicamento en su mochila. Los ejemplos incluirían Tylenol, Ibuprofen, Tums, Midol, etc.

This page was translated using Google Translate.

Esta página fue traducida usando Google Translate.