• Protocols


    Each Specialized Physical Healthcare Procedure (SPHCS) are NOW with specific authorization form posted next to the protocol guideline below. The authorization form has both the parent and licensed healthcare provider in one page with the parent section available in four languages.
A. Specialized Health Care Services
    Form2017/2018 (5/2017) | 2018/2019 (5/2018)
    Guidelines, (Rev. 4/2017) 
G.  Protocol and Medication Checklist Form- Medication/Protocol Checklist for Licensed and Unlicensed
        Assistive Personnel
H. Review for Support Services Due to Health Needs -Complete for Student with Protocol Before the IEP
Protocols Guidelines: 
(1) Anaphylactic Reaction to Immunizing Agent (Emergency Care Protocol), (11/2017) 
(2) Anaphylaxis Protocol for Identified Students Emergency Treatment of Anaphylaxis (05/2016)
Authorization Forms: (5/2017):
Epinephrine for Schools: REF - 6632.1 Administration of Epinephrine Auto-Injectors, March 2016
Authorization Forms: (5/2017)
a. Clean Catheterization Guidelines (Rev. 1/18)
   Authorization Forms for Clean Catheterization (5/2017)
    Authorization Forms for Clean Self-Catheterization with Assistance (5/2017)
c. Clean Self-Catheterization Guidelines (Rev. 1/16)
   Authorization Forms for Clean Self-Catherization (5/2017)
d. Sterile Catheterization Guidelines (Rev. 05/2016)
   Authorization Forms for Sterile Catheterization (5/2017)
1. Blood Glucose Testing (6/2017)
2. Hypoglycemic Reaction (6/2017)
3. Glucagon Injection (Severe Hypoglycemia) (6/2017)
Authorization Forms 
Other Related Forms and Information

For LAUSD Food Services Web Page for Menu click here; for carbohydrate count click here.


    Authorization Forms for Gastrostomy Feeding: Bolus Method (5/2017) 
    Authorization Forms for Gastrostomy Feeding: Slow Drip Method or Pump (5/2017) 
    Authorization Forms for Gastrostomy Tube Replacement (5/2017) 
 Authorization Forms for Jejunostomy Tube Feeding: Slow Drip Method or Pump (5/2017) 
Authorization Forms with the Parent Section in Different Languages (5/2017) 
Mechanical Ventilation Guidelines (Rev. 5/2016)
 Authorization Forms for Mechanical Ventilation (5/2017) 
Other Related Forms/Information 


Ostomy Care (Rev. 4/2017)

Authorization Forms with the Parent Section in Different Languages (5/2017) 
Oxygen Therapy - Guidelines (Rev. 12/15)
Authorization Forms for Oxygen Therapy (5/2017)
1.  Diastat - Diastat Guidelines  (11/15)
Authorization Forms for Diastat (5/2017)
2.   Vagus Nerve Stimulation (VNS) - VNS Guidelines (2/15)
Authorization Forms for VNS (5/2017)
Related Forms and Information
      c. Seizure Action PlanEnglish/Spanish
      d. Seizure Record
      e. Parent Questionnaire for Students with Seizures
          (1) English/Spanish (2)  English/Armenian (3) English/Chinese (4) English/Korean
   1. Oral Nasal Suctioning (Rev. 6/15)
       Authorization Forms for Oral/Nasal Suctioning (5/2017)
      Authorization Forms for Oropharyngeal and Nasopharyngeal Suctioning (5/2017)
   3. Tracheostomy Suctioning (Rev. 6/15)
      Authorization Forms for Tracheostomy Suctioning (5/2017)
   4. Tracheostomy Tube Replacement (Rev. 6/15)
      Authorization Forms for Tracheostomy Tube Replacement (5/2017)
Related Forms:
  • Announcements

    Immunization Program and SMS School-based Clinics Schedule

     CPR Class Schedule    LAUSD American Heart Association