Health Forms and Immunization Information

Student Health Information

  • The following information is to assist you, as the parent/guardian, with providing health information required for your child by Broward County Public Schools. If you should have any questions, please feel free to contact your school.  

    Print Parent Health Letter

  • COVID-19 Vaccination

    You may voluntarily notify your school if your child has been fully vaccinated. 

  • Student Health Services Consent Forms

    The Student Health Services Consent Form should be completed, signed, and dated by the parent/guardian to ensure students can receive health services at school or in school-sponsored activities.

  • Medical Examination

    All students entering Broward County Public Schools for the first time must have a medical examination performed within one year of registration. The medical examination should be documented on the Florida Department of Health Form 3040 or the provider’s office/medical facility stationery. The appropriate form/stationary should be completed, signed, and dated by the healthcare provider.

  • Please keep your child home if your child has a communicable diseases/illnesses

    Please inform the school if your child is out sick with a diagnosed communicable illness such as COVID-19, meningitis, measles, salmonella, etc.

    • Flu-like symptoms 
    • Fever greater than 100.4 degrees 
    • Persistent cough
    • Headache
    • New loss of taste or smell
    • Shortness of breath/difficulty breathing
    • Chills
    • Muscle or body aches
    • Vomiting
    • Diarrhea 
    • Fatigue 
    • Congestion or runny nose
    • Sore throat 
    • Rashes, yellow eye drainage, or greenish-yellow phlegm 

  • Chronic Health Conditions

    If your child has any of the following health conditions, including, but not limited to, asthma, diabetes, cystic fibrosis, sickle cell anemia, seizures, allergic reactions to food, insect bites, etc., please inform the school. 

    Parents should:

    • Document the chronic health condition on the Student Emergency Contact Card and complete the history on the back of the card
    • Meet with school administration to discuss the care of the student while at school 
    • Provide the school with a current Medication Authorization form signed by the healthcare provider and parent, if the student is on medication 

    Note: The healthcare provider and parent must complete a Diabetes Medication/Treatment Authorization form for students with diabetes. Students who received insulin via an insulin pump must also complete an Insulin Pump Medication/Treatment Authorization form.

  • Medication Administration at School (Prescription or Over the Counter)

    • No medication will be administered in school or during school-sponsored activities without the parent’s/guardian’s written authorization and a written authorized prescriber order. This includes both prescription and over-the-counter (OTC) medications

    • A new Medication Authorization Form must be completed every 12 months or when changes are made to an existing Medication Authorization.  The parent/guardian is responsible for filling out Part 1 and obtaining the authorized prescriber's order and signature on Part II. Information necessary includes the student’s name, diagnosis, allergies (specify none or n/a if there aren’t any), medication name, the strength of the medication, dosage, time of administration, route of administration, possible side effects, prescriber’s signature and date
       
    • All medications will be administered by onsite healthcare personnel or by a trained school staff member designated by the principal 

    • The medication must be delivered to the school by the parent/guardian or, under special circumstances, an adult designated by the parent/guardian. All medication must be signed into the clinic by the parent/guardian and counted with the school health nurse or school personnel. Medication delivered by the student will not be administered by the school health nurse or school personnel

    • All prescription medication must be provided in an original pharmacy container with the pharmacy label attached. The pharmacy label cannot be expired. Non- prescription OTC medication must be received in the original packaging with the safety seal intact 

    • The first day’s dosage of any new non-emergency medication must have been given at home before it can be administered at school

    • The parent/guardian is responsible for collecting any unused portion of medication after the expiration date of the medication or expiration date of the authorized prescriber’s order. If the medication is unclaimed by the parent/guardian after three contact attempts, the medication will be forwarded to the Risk Management department and will be destroyed 

    • An authorized prescriber’s order and parent/guardian permission are necessary for self-carry/self-administered emergency medications such as inhalers for asthma or epinephrine auto-injectors/AUVI-Q auto-injectors for anaphylaxis. The student must understand the necessity for reporting to either the school nurse or school staff members that they have self-administered their inhaler without any improvement or have self-administered an epinephrine/AUVI-Q auto-injector so 911 may be called 

    • The school nurse will call the authorized prescriber, as allowed by the Health Insurance Portability and Accountability Act (HIPAA) if a question arises about the student and/or the student’s medication 

  • Authorization for Selected Over-the-Counter Medication (OTC) with Parental Approval (Grades 9-12 Only)

    If your child needs to take over-the-counter (OTC) medication at school or on a field trip, an Authorization for Selected (OTC) with Parental Approval form must be completed and signed by the parent/guardian, student and be notarized. Self-carry, self-administration of the selected over-the-counter medications only: 

    • Tylenol
    • Midol
    • Ibuprofen
    • Tums
    • Allegra
    • Claritin
    • Lactaid

  • Authorization for Over-the-Counter (OTC) Topical Products with Parental Approval

    • Students in all grade levels are permitted to self-carry and self-administer bug, insect, mosquito repellent (wipes, towelettes, or lotions only) and sunscreen (no aerosol products permitted)
    • An Authorization for Over-the-Counter (OTC) Topical Products with Parental Approval Only form must be completed and signed by the parent/guardian

    Note: Plan for field trips if your child needs medication for an overnight trip that he/she may not normally take at school. Update changes to your child’s health condition as they occur.

  • Immunizations (Please refer to F.S. 1003.22)

    • Make sure your child’s required immunizations are up to date. If you are not sure, you can check with your healthcare provider or the Florida Department of Health-Broward at (954) 467-4700
    • Parents may obtain medical exemptions from their healthcare provider or a religious exemption from the Florida Department of Health-Broward

  • School Health Centers, Community Resources, Immunizations & Health Care

    • If you do not have insurance, you can request an application for Florida KidCare Insurance at your child’s school
    • The Florida Heiken Children’s Vision Program provides vision examinations and eyeglasses when prescribed, to students in need of comprehensive vision services at no cost to the student
    • The Florida Heiken Program consent form will be sent home during the first week of school for parent/guardian signature or it can be accessed online at www.floridaheiken.org.  Sign and return the form if you want your child to participate

Contact Information

  • Coordinated Student Health Services

    1400 NW 14 Court

    Fort Lauderdale, Florida 33311

    Phone: 754-321-1575

    Fax: 754-321-1695

    TTL: --

    Phone: --

    Gail R. Adams, BSN, RN

    Director (Task Assigned)