Medical Forms

Below are the various Diocesan and school medical forms that parents need. We have centralized them on this page for easy access and reference.

1. Virginia School Entrance Health Form
2. Medical Authorization – Not for Epipen or Inhaler
3. Allergy Related
4. Diabetes
5. Elevator Use
6. Immunization Exemption Form

• VA School Entrance Health Form
• VA School Entrance Health Form Instructions

• Medication_Authorization_Form

• Allergy Action Form (Includes epi-pen use)**
• Inhaler Authorization Form
• Asthma Action Plan **
  **All students requiring an epi pen or an antihistamine must also complete these forms.

• Diabetes Medical Mgt Plan
• Diabetes Reference Emergency Plan Part A & B

Any student needing to use the elevator must have this form completed by a doctor and returned to the school nurse.  Student must be escorted on the elevator by a faculty member.  No more than one student may accompany the injured student and faculty member.

• Elevator Use Form

• Certificate Religious Exemption