Bill Roberts Health Office Forms
Instructions for Medications
In order to give your child the best care possible, we need to be as detailed as possible! There are four forms that are unique to the different medical needs of students.
- Epi Pens
Colorado Allergy and Anaphylaxis Emergency Care Plan & Medical Orders
Colorado School Asthma Care Plan
- Asthma (If desired for your child to keep the inhaler with them and self-administer)
Contract for Students Carrying/Self Administer of Inhalers While at School
- All other meds.; e.g. (Benadryl (antihistamines), eye drops, Tums, Tylenol, Ibuprofen, daily medications, etc.
Student Medication Request Release Agreement
All of these forms REQUIRE very specific instructions. Please fill out your portion, with your signature and emergency numbers and then give it to your doctor to complete.
Your doctor’s office can fax the form back to us in the health office:
Bill Roberts Fax 720-424-2665
You may deliver your medication(s) to the school after we have received the appropriate forms.
There will absolutely be no medications, of any kind, given to a child without proper doctor’s orders.
Thank you so much!