Westfield Washington Schools

Health & Wellness » Medical Emergency Action Plans

Medical Emergency Action Plans

If your child has a medical condition that requires the use of emergency medication or a specific medical treatment, please print out and complete the form below with your child's physician and hand into your school nurse.  Your school nurse will work with you to create a individual plan to guide care during the school hours or school related events. The emergency plan or individual medical care plan must be submitted every year to the school nurse.  If you have questions or concerns or need additional forms, please call your school nurse. (See the School Nurse Directory on this website)

See appropriate plan(s) for your child below. Print out, complete the information, including physician's signature when needed and return to your school nurse.
  • Severe Allergy complete a Allergy History Form & Anaphylaxis Emergency Care Plan
  • Asthma complete a Asthma Management Plan
  • Seizure complete a Seizure History Questionnaire & Seizure Action Plan
  • Diabetes- Please complete a Parent Questionnaire and send in a Treatment & Management Plan from your child's physician prior to the first day of school