St. Helena Unified School District

Medication Forms:
 If your child needs to take medication during school hours, fill out the form below with your healthcare provider and deliver it to the school.  This form must be renewed annually.  

Medications must be picked up at the end of each school year. Medication must come to the front office with form completed and signed by parent/guardian and healthcare provider, and:

• be properly labeled in a bag with the student's name and grade
• in original container with expiration date
• prescription medications must have the name/telephone of the pharmacy, the student's name, and name and phone number of the healthcare provider.

Emergency Health Plan Forms:

Release of Information Forms:

English Concussion Information

Espanol Informacion Sobre Conmocion Cerebral

CIF Return to Learn, (Spanish)

CIF Return to Play, (Spanish)

Dental Van Information

Type 1 Diabetes

Parent information (CA Ed Code Section 49452.6)                          

Type 2 Diabetes  

Parent Information (CA Ed Code Section 49452.7)

Use of Crutches, Walkers or Wheelchairs in School

English

Spanish