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Dickinson ISD policy allows school nurses and other school employees to administer medication to students during school hours should medication be necessary to keep a student in optimum health and to maintain maximum school performance under the following conditions:

The school district has a consent on file to administer medication that has been signed by the parent, legal guardian, or other person having legal control of the student along with the prescribing physician’s signature.



Prescription medication must be in the original container properly labeled with child's name, name of medicine, and directions for time and dosage.


Non-prescription medication shall be in the original container clearly labeled as content. Student's name and directions for time/dosage shall be provided by the parent/guardian at the time the request to administer the medication is made. 

Click here for DISD Administration of Medication Form


The parent or guardian is responsible for notifying school personnel of the presence of a severe anaphylactic food allergy. Upon enrollment, a parent or guardian must indicate if their child has a severe food allergy (see Request for Food Allergy Information Form). 


Parents are required to complete and provide the following at the beginning of each school year:



  Special Dietary Accomodations Request Form (español)


  • The Authorization for Self-Carry and Self-Administration of Anaphylaxis Medication (EpiPen) must be indicated by physician on Food Allergy Action Plan, if applicable.




Effective asthma management in school can help improve a child’s learning environment, reduce absences, reduce classroom disruptions and help children feel safe at school. School staff need to know which children have asthma and understand their individual needs regarding their asthma.


Parents are required to provide a Asthma Action Plan, completed and signed by the child's physician at the beginning of each school year.





House Bill 984 requires that:

  • An individualized health care plan be developed for each student with diabetes who will seek care for diabetes while at school or while participating in a school activity.  The plan must be submitted:
    • Before or at the beginning of each school year, upon enrollment, or as soon as practicable following diagnosis.
    • Developed and signed by the student’s parent/guardian and the physician responsible for the student’s diabetes. and must include:
      • The health care services the student may receive at school.
      • Evaluate the student’s level of understanding and ability to manage their diabetes.

A particular form is not required.  However, a sample has been provided for your convenience.

Sample Diabetes Care Plan

Student Contract for Self Management of Diabetes

The parent/guardian must also sign an agreement that authorizes an unlicensed diabetes care assistants to assist the student in the absence of a school nurse.  The school nurse will provide a copy for you to sign.



Dickinson ISD follows the Epilepsy Foundation standards and recommendations to provide care for students with seizures.  Parent/Guardians are responsible for notifying school personnel if their child has a history of seizures. 


Parents are required to provide a Seizure Action Plan, completed and signed by the child's physician at the beginning of each school year.

Gastrostomy Tube Feeding Authorization Orders


For students who require gastrostomy tube feedings during the school hours, parents are required to provide Physician Orders for Gastrostomy Tube Feeding completed and signed by their physician at the beginning of each school year. 


 Special Procedures authorization orders

For students who require special procedures during the school day, such as catheterization, suctioning, diapering, trach care, oxygen or any other special procedures, parents are required to provide a Special Authorization Orders completed and signed by the child's physician at the beginning of each school year.
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