School Forms

For your convenience, the following school forms are available for download as well as from your school:

School Health Form

Student Absence Form

ASTHMA 

The Waterbury School Nurses are standardizing around the use of one Asthma form developed by the CT State Department of Public Health. The new standardized form combines authorization for medication in schools for up to 3 Asthma medications into 1 overall Asthma-specific form, which is an improvement over the previous use of 1 authorization form per medication. As an added benefit, the combined Asthma authorization form also incorporates an Asthma Action Plan which provides the providers’ directions to all care givers for the specific child with asthma.

Please see the new standardized Asthma form at the following link:  

NEW ASTHMA FORM:
 1. Asthma Medication Authorization and Asthma Action Plan

Waterbury Public Schools
236 Grand Street
Waterbury, CT 06702
Phone: (203) 574-8000

Fax: (203) 574-8010