Centerville Elementary Forms

Anaphylaxis Action Plan

For those requiring emergency EPINEPHRINE treatment. Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Contact your student's building nurse to discuss a plan.

Diabetes Management Plan for School

Contact your student's building nurse to discuss a plan.

Medication Authorization

Contact your student's school nurse to plan for the administration of medication at school

Seizure Action Plan

Does your child experience seizures? 

What should be done if one occurs during school?
What special considerations need to be made?

Contact your student's building nurse to discuss a plan.

Title VII Student Eligibility Certification (pdf, 16 KB)

Title VII Student Eligibility Certification