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Degrees and Certifications:
This form may be filled out by your doctor if student has a Seizure Disorder.
This form may be filled out by your doctor if student has a SEVERE food allergy (peanuts, etc) that requires an EPIPEN or other medication.
Complete this form if your student has Diabetes and requires medication (Insulin) at school.
Use this form if your student has a SEVERE allergy requiring an EPIPEN or other medication.
Use this form for self carrying of inhalers or EPIPENs
Use this form if your doctor requires the school nurse to give a medication during school hours.
This form allows the school nurse to speak with your doctor.
411 ESE Loop 323 | Tyler, TX 75701Phone: 903.262.2625 | Fax: 903.262.2630
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