North Santiam School District

1) Does your child have an ongoing health condition? If yes, please complete the fillable pdf below and return it to their school office via printed copy or email. 

Ongoing Health Condition Supplemental Form (English)
Ongoing Health Condition Supplemental Form (Spanish)

2) Does your child have asthma? If yes, please complete the fillable pdf below and return it to their school office via printed copy or email. 

Asthma Supplemental Form (English)
Asthma Supplemental Form (Spanish)

3) Does your child have a serious or severe allergy? If yes, please complete the fillable pdf below and return it to their school office via printed copy or email. 

Severe Allergy Supplemental Form (English)
Severe Allergy Supplemental Form (Spanish)

4) Does your child have a seizure disorder? If yes, please complete the fillable pdf below and return it to their school office via printed copy or email. 

Seizures Supplemental Form (English)
Seizures Supplemental Form (Spanish)

5) Will your child need to be administered medication at school by district staff? If yes, please complete the fillable pdf below and return it to their school office via printed copy or email. 

Medication Permission Form (English)
Medication Permission Form (Spanish)

6) Do you wish to grant your child permission to administer their own medication at school? *Special conditions apply* In grades K-8 , this is only available for some inhalers or epi-pens. If yes, please complete the fillable pdf below and return it to their school office via printed copy or email. 

Self-Medication Permission Form and Agreement (English)
Self-Medication Permission Form and Agreement (Spanish