Seizure Forms

  • For students with a history of seizures.
    To best meet your student's needs at school, we ask you complete the two below documents. All student health information is confidential and will only be shared with faculty/staff who work with your student. Please complete and return to the health office at the campus where your student will be attending the upcoming school year before the first day of school.
    • Parent Questionnaire for a Student with Seizures: Please complete the questionnaire as your information is essential for the school nurse and school staff in determining you student’s special needs and providing a positive and supportive learning environment.
    • Seizure Action Plan: developed by the Epilepsy Foundation should be completed by your student’s treating physician. All student health information is confidential and will only be shared with the staff on an as needed basis.
    Thank you for your help in ensuring a safe environment for your student, while maximizing opportunities for learning and development. Feel free to contact the health office if you have any questions.

Forms