• Protocols

    Each Specialized Physical Healthcare Service (SPHCS) now has the specific authorization form posted under the protocol guideline. This form requires the signature of the licensed healthcare provider and parent on one page.  The parent section is available in four languages.




Solu-Cortef Protocol Guidelines


Authorization Forms:

English/Spanish - Other languages are not available

Emergency Medication Authorization


Related Forms and Information:

Emergency Care Plan for School

Adrenal Insufficiency - Power Point



Protocols Guidelines: 
For Immunization Clinics' Use Only -  Anaphylactic Reaction to Immunizing Agent (Emergency Care Protocol), (10/2018) 
For School - Anaphylaxis Protocol Emergency Treatment of Anaphylaxis (03/2019)
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 (3/2019)
   Authorization Forms for Clean Catheterization (5/2017)
    Authorization Forms for Clean Self-Catheterization with Assistance (5/2017)
c. Clean Self-Catheterization Guidelines (3/2019)
   Authorization Forms for Clean Self-Catherization (5/2017)
d. Sterile Catheterization Guidelines (3/2019)
   Authorization Forms for Sterile Catheterization (5/2017)
1. Blood Glucose Testing (3/2019)
2. Hypoglycemic Reaction (3/2019)
3. Glucagon Injection (Severe Hypoglycemia) (3/2019)
Authorization Forms:
3. Glucagon Injection (1/2020)
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) 
Mechanical Nebulizer Treatment - Guidelines (3/2019)
Authorization Forms with the Parent Section in Different Languages (5/2017) 
Mechanical Ventilation Guidelines (3/2019)
 Authorization Forms for Mechanical Ventilation (5/2017) 
Other Related Forms/Information 


Ostomy Care (3/2019)

Authorization Forms with the Parent Section in Different Languages (5/2017) 
Oxygen Therapy - Guidelines (3/2019)
Authorization Forms for Oxygen Therapy (5/2017)
A. Specialized Health Care Services:
   (1)  Form
   (2)  Guidelines
C. Healthcare provider and parent authorizations are NOW protocol-specific.         
    See specific protocol section.
        Assistive Personnel
H. Review for Support Services Due to Health Needs -Complete for Student with Protocol Before the IEP
1.  Diastat - Diastat Guidelines  (3/2019)
Authorization Forms for Diastat (5/2017)
2.   Vagus Nerve Stimulation (VNS) - VNS Guidelines (3/2019)
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 (3/2019)
       Authorization Forms for Oral/Nasal Suctioning (5/2017)
      Authorization Forms for Oropharyngeal and Nasopharyngeal Suctioning (5/2017)
      Authorization Forms for Tracheostomy Suctioning (5/2017)
      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