Health Wellness Forms

Required Forms

Virginia School Entrance Health Form

This form is required for all students new to Strelitz Early Childhood Education Center and must be completed and reviewed by a nurse prior to starting school.

Additional Forms

Medication Administration Form

If your child needs over the counter or prescription medication administered during school hours, this form is required.

Asthma Action Plan

If your child requires or may require an inhaler or nebulizer during school hours, please have this form completed and brought to school with the inhaler and spacer.

Life Threatening Allergy Medical Plan (LAMP)

If your child has a life-threatening allergy that requires epinephrine, antihistamine and/or inhaler administration, this plan must be completed by his or her physician for each school year. Please provide two unexpired Epi-pens (or Auvi-Qs), plus antihistamine and needed an inhaler, per the physician’s orders.

K – 5th Grade

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6 weeks – 4 years

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