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Health Forms
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6th Grade Medical Records Form
Prior to students entering 6th grade at Mt. Pleasant Middle School, a medical records form must be completed and returned to the school nurse. -
Asthma Treatment Plan
If a student has asthma, an Asthma Treatment Plan must be on file in the student's health records. Please return the completed form to the school nurse.
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Athletics - Preparticipation Physical Evaluation
For those students wishing to participate in an interscholastic/intramural sport or club program (requiring a physical, i.e. dance club).
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Confidential Medical Information Update Form
confidential_medical_update_form_2017 - returning students.pdf 154.94 KB (Last Modified on December 22, 2017) -
Physician's Orders for Allergy Emergency Treatment (Epipen)
Physicians Order for Allergy Emergency Treatment - Epipen.pdf 13.40 KB (Last Modified on August 26, 2015) -
Self-Medication Law 1-2600 Form
For Asthma and Life-Threatening Conditions.