Skip To Main Content

Individual Health Plans/Emergency Care Plans and Health Information Sharing

Does your student have Asthma, moderate-severe Allergies, Diabetes or any other health condition that may warrant intervention while at school? Please connect with our school nurse!  Those students with asthma, severe allergies requiring an EpiPen, diabetes, seizures etc., must have a health plan specific to their condition. These Individual Health Plans/Emergency Care plans are written by the School Nurse using information from families and from Medical Provider documents. These completed forms will be kept in the main office and distributed to teaching staff on an as-needed basis.  

Health history form

Asthma action plans in English and Spanish:

Asthma Action Plan

Asthma Action Plan (Spanish)

Dietary accommodations forms in English and Spanish:

Request for Special Dietary Accommodations

Request for Special Dietary Accommodations (Spanish)

Epinephrine district policy:

  • Search for Policy 3420 at this link

SJISD ROI form

Seattle Children’s ROI forms in English and Spanish:

Seattle Children's ROI Form in Spanish

Seattle Children's ROI Form in English

FERPA 

Under the Family Educational Rights and Privacy Act (FERPA) school districts may disclose directory information if they have given public notice to parents/guardians and eligible students of what information has been designated as directory information, and when and how parents/guardians and eligible students may opt out of allowing the district to disclose their directory information. 

Please see linked form for opting out of several categories of “directory Information’, including the annual “Student Directory” phone book published by the San Juan Island Public Schools Foundation.  Look for the FERPA form on our website at https://www.sjisd.wednet.edu/domain/34