Achsd 2026

1. Click ‘Get Form’ to open the achsd in the editor.
2. Begin by entering the student's name and birth date in the designated fields. Ensure accuracy for proper identification.
3. Select the school from the dropdown menu, which should be pre-filled with 'Coulee-Hartline School District'.
4. Fill in the grade of the student to provide context for medication administration.
5. In the Licensed Health Professional (LHP) section, document the diagnosis or reason for medication clearly.
6. Indicate the severity of the problem by checking one of the options: mild, moderate, or severe.
7. List any activity modifications or restrictions that may apply to ensure student safety.
8. Complete details about each medication including name, dosage, method of administration, and frequency if PRN.
9. If applicable, describe indications for PRN medications and signs for Epi-Pens usage.
10. Answer whether the student can travel on field trips more than 30 minutes away from emergency medical response.
11. Document possible side effects of medications as required.
12. Confirm if the student is capable of self-administration and can carry their medication responsibly by checking 'Yes' or 'No'.
13. Finally, both LHP and parent/guardian must sign and date their respective sections to authorize medication administration.

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