Health Office Information

 

Robyn Lee Acosta, nurse

ebertr@nv.ccsd.net

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Aspen Ebert, FASA

ebertam@nv.ccsd.net

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Health Office Forms

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• CCSD Student Health Card (CCF-768)

  • Electronic substitute form during COVID​

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• Request to Authorize Student Self-Administration of Prescribed Medication for Asthma/Anaphylaxis (HS-96)

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• Parent/guardian request for medication assistance (CCF-643)

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• Physical Activity Medical Report Form (CCF-652)

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• Anaphylaxis Orders (HS-166)

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• Diabetes Orders (HS-171E)

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• Diabetes Permission for Self Care (HS-178)

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• Nebulizer Treatment Orders (HS-201)

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Immunization Information:

 

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• CCSD Quick Immunization Reference Guide 2021-2022

 

• Medical Immunization exemption form (English)

 

• Medical Immunization exemption form (Spanish)

 

• Religious Immunization exemption form (English)

 

• Religious Immunization exemption form (Spanish)