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  • Parent Resources

Home/Hospital School

Referral Forms: Home Medical Referral

                            Hospital Medical Referral

                            Psychiatric Referral

                            Non-Medical Referral for Home Instruction


Medication

Request for Medication to be Taken During School Hours, Form 33.199 (Feb 2023)

Asthma Action Plan English/Spanish Jan 2024

Request for Self-Admin of Medication, From 33.205 (March 2023)

Request to Self-Carry Emergency Medication (English)

Request to Self-Carry Emergency Medication (Spanish)


Permanent Health History

English -  Spanish

English - Armenian

English - Chinese

English - Farsi

English - Korean

English - Russian

English - Tagalog


Release of Medical Information

Authorization to Receive/Release Medical Information  


Special Diet

Medical Statement to Request for Special Diet

 

 Shots for School

 

In-Home COVID Vaccine for Homebound LA County Residents  

Please contact 211 for assistance with basic needs and other resources at https://211la.org/search-resources

Health Brochures

My Child Has A Health Problem

My Child Has A Health Problem

 

 

My Child Needs Medication/s in School

My Child Needs Medication
in School

 

 

 

My Child Has Medical Treatment/s

My Child Needs Medical Treatments During
the School Day

 

 

 

My Child Has Severe Allergies

My Child Has Severe Allergies

 

My Child Has Asthma

My Child Has Asthma

 

My Child Has Diabetes

My Child Has Diabetes

 

 

 

 

 

My Child Has Seizures

My Child Has Seizures

 

 

 

 

SPHCS Guidelines

Authorization Form

Adrenal Insufficiency Care

Solu-Cortef Protocol Guidelines  

Authorization Form for Emergency Medication for Adrenal Insufficiency and Student Emergency Care Plan

English

Spanish

Anaphylaxis English-Spanish
Autonomic Dysreflexia English-Spanish
Catheterization, Clean English-Spanish
Catheterization, Sterile English-Spanish
Clean Self Catheterization with Assistance English-Spanish
Clean Self-Catheterization English-Spanish

Diabetes Care

Blood Glucose Testing

Hypoglycemia

Glucagon

Baqsimi

Hyperglycemia Treatment

Gastrostomy - Bolus Method Feeding English-Spanish
Gastrostomy - Slow Drip Method or Pump English-Spanish
 Gastrostomy  - Replacement English-Spanish
Jejunostomy - Slow Drip or Pump English-Spanish
Oral - Nasal Suctioning
English-Spanish
Oropharyngeal and Nasopharyngeal Suctioning English-Spanish
Ostomy Care English-Spanish
Oxygen Therapy English-Spanish

Seizure Care - Action Plan

English-Spanish
Seizure Care- Parent Questionnaire English-Spanish

Seizure Care - Nasal Benzodiazepines (Nayzilam & Valtoco)

 English-Spanish

Seizure Care - Diastat Administration

English-Spanish

Seizure Care - Vagus Nerve Stimulation

English-Spanish
Tracheostomy - Suctioning English-Spanish

Tracheostomy -Tube Replacement

(Emergency Procedure Only)

English-Spanish

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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    Contact Info

    121 N. Beaudry Ave.,
    Los Angeles, CA 90012 
    P: (213) 202-7580
    F: (213) 580-6557
    E: DistrictNursing@lausd.net

    Director:
    Sosse Bedrossian, MSN, MA, RN, FNP-C

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