Corona Virus Response and Recovery

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

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)

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

Permanent Health History

Permanent Health History Form  

Release of Medical Information

AUTHORIZATION TO RECEIVE/RELEASE MEDICAL INFORMATION  

Special Diet

Medical Statement to Request for Special Diet