District-specific / AAFA / ADA · School districts / AAFA / ADA
Plan for managing health emergencies at school (anaphylaxis, seizures, asthma attacks, diabetic emergencies). Includes medication instructions and emergency contacts.
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Submit to the school nurse and main office
Provide copies to every relevant staff member (teacher, PE teacher, cafeteria staff, after-school program).
Mail to the school nurse before the start of the school year
Filing Deadline
Submit before the start of the school year or immediately upon diagnosis of a condition requiring an EAP.
Typically reviewed and activated within 1-5 school days. The school nurse will distribute copies to relevant staff.
The school nurse will review the plan, train relevant staff, and ensure emergency medications are stored appropriately. The plan should be reviewed and updated annually or when the condition changes.
State-specific · USDA Food and Nutrition Service (state-administered)
Application for WIC nutrition assistance providing education, breastfeeding support, and benefits for healthy foods. Requires proof of identity, address, income (or Medicaid/SNAP/TANF participation), and a health screening.
State-specific · State WIC agencies
Medical documentation of nutrition risk factors qualifying an individual for WIC, such as anemia, underweight, or high-risk pregnancy.
State-specific / Healthcare.gov · State CHIP agencies
Application for Children's Health Insurance Program for families with income too high for Medicaid but too low for private coverage. Uses MAGI-based financial eligibility. Children must be uninsured.
State-specific (e.g., VA MCH213G) · State Departments of Health/Education
Required for school entry. Includes immunization records, health history, physical examination, and developmental screening. Must be completed no earlier than one year before school entry.
State-specific · State Departments of Health
Official record of required childhood vaccinations for school enrollment. Exemption forms (medical, religious, philosophical) vary by state.
District-specific · School districts
Authorization for school nurse or designee to administer prescribed medication during school hours.
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