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	Welcome to the Madison County Health Department School Forms		The Web Madison County HD Local Agencies Berea Independent Schools Madison County Schools State Agencies Department of Public Health Department of Education Kentucky Board of Nursing National Agencies American Academy of Pediatrics Diabetes for Parents Diabetes Nutrition Allergies CDC School Health Immunize.Org National Association of School Nurses Seizures
	Please click on the form name to view or right-click (control-click on a Macintosh) to download a copy.
	Parental Consent Form, 2009-2010
	Privacy Policy	Aviso de Praticas de Privicidad

	Emergency Procedures Guide
	Emergency Procedures Guide
	Allergy Emergency Procedure	Asthma Emergency Procedure
	Diabetes Emergency Procedure	Seizure Emergency Procedure

	Medication Permission Forms
	Permission for Prescribed and Over-The-Counter Medications	Formulario de Autorización para Medicamentos bajo Prescripción y Sin Prescripción Medica
	Epi-Pen Administration with Permission Form	Glucagon Administration with Permission Form
	Dental Permission Forms
	Fluoride Varnish Consent	Sealant Consent & Dental History







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Madison County Health Department 216 Boggs Lane / Richmond / Kentucky / 40475 859-623-7312