COOPER HEALTH OFFICE
  • Home
  • Mrs. Fleischmann
  • Health Topics
  • Immunizations
  • medication, asthma and entrance physical form
  • Administration of Epinephrine
  • Middle School Sports Physical Information
​Administration of Epinephrine

 If your child has a life threatening allergy and may require the administration of Epinephrine and/or Benadryl while at school, the following forms (all 5 tabs) are required. 


Medication will not be accepted in the nurse’s office without the proper completion of the below forms. All medication must be in the original containers.  Epipens should not be expired and must have a prescription label which matches the doctor's order.


*Cherry Hill Public Schools- Management of Life-Threatening Allergies in School Policy
Picture
anaphylaxis/food allergy plan
File Size: 629 kb
File Type: pdf
Download File

epipen unlicensed personnel form
File Size: 26 kb
File Type: pdf
Download File

epipen order delegate form
File Size: 64 kb
File Type: pdf
Download File

administration of epinephrine form
File Size: 73 kb
File Type: pdf
Download File

medication administration form
File Size: 15 kb
File Type: docx
Download File

Powered by Create your own unique website with customizable templates.
  • Home
  • Mrs. Fleischmann
  • Health Topics
  • Immunizations
  • medication, asthma and entrance physical form
  • Administration of Epinephrine
  • Middle School Sports Physical Information