Los Angeles Unified School District

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E-Library works best using Google Chrome Chrome  
 
 
The forms are listed with a sub list of forms that will be needed to complete the necessary documentation.
 
AED Daily/Monthly Readiness Status Checklist
 
 
Asthma 
      ACT Under 12: (1) English  (2) Spanish
      ACT Over 12  : (1) English  (2) Spanish
 
 
CHDP FORMS 
 
 
Chickenpox Notification
   2. For Employees 
 
 
Condom Availability Program
 
 
Confidential Health Information for a Student 
   1. General
   2. With Asthma 
   3. With Diabetes 
   4. With Seizures
 
 
Daily Log 
 
 
Dental 
Diabetes 
 
 
Ear, Nose, and Throat Observation 
 
 
 
 
 
 
 
 
Head Injury 
Cautions Regarding Head Injury Forms
   2.  English/Korean
   3.  Notice of First Aid 
 
  
 
IEP 
Immunizations
 
 
 
 
 
 
 
 
Pediculosis (Head Lice) 
Pediculosis Fact Sheet (English & Spanish), June 2016
 
Receive/Release of Medical Information Authorization 
 
 
Reports
 
 
Scoliosis Screening
   1.  Scoliosis Screening Program-Waiver
 
 
Special Diet Request Form
See Protocol for Emergency Treatment of Anaphylaxis under Protocol section of the Nursing Forms
 
 
 
 
Stull 
 
 
Suctioning 
 
 
TB Risk Assessment Questionnaire: Pediatric TB Risk Assessment Questionnaire
         English  |   Chinese   |   Spanish   |   Tagalog   |   Vietnamese 
Tuberculosis Screening 
 
 
Tdap  
Time Reporting: 2016-2017
 
 
Time Reporting: 2017-2018 
 
Z- Time -  USE Google Chrome Chrome
Z-Time Reporting (Additional Work Time) - Fund column will be completed by the Immediate Supervisor.  
 
Mileage Statement -  Daily Mileage Statement
 
Certification of Absence
 
 
Training Log
 
 
Vision Screening 
Report of Vision Screening 
   1. English
   2. Spanish
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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