Sioux City Community Schools -

Dental Screening Certificate Form (Form to be Completed by Health Provider)
Dental Screening Exemption Form

Anaphylaxis Individual Health Plan Form
Anaphylaxis Individual Health Plan for Non-Food Allergies Form
Asthma Individual Health Action Plan Form
Diabetes Individual Health Plan Form
Questionnaire for Parents of a Child with a Seizure Disorder Form
Special Dietary Request Form

Authorization for Administration of Asthma or Other Airway Constricting Disease Medication Form
Authorization for Medication or Procedure Administration Form
Certificate of Immunization Form (Form to be Completed by Health Provider)
Certificate of Immunization Exemption Form – Medical (Form to be Completed by Health Provider)
Certificate of Immunization Exemption Form – Religious
IDHP Master Index Card (Form to be Completed by Health Provider)
Provisional Certificate of Immunization (Form to be Completed by Health Provider)

Vision Screening Certificate Form (Form to be Completed by Health Provider)