Please be reminded that the Hillsdale Board of Education, under state mandate, requires a physician's written order and parent signature in order to dispense any prescribed or over the counter medication to a student.

This form is required for Self-Administration of Asthma Inhaler Medication or other potentially life threatening illness.

This three page document is required to allow for administration of Epi-Pen. Also included is the Emergency Health Care Plan.

If you would like your child to sit at the Peanut/Tree Nut Free Table

please fill out this form.