health Services

The Department of Health Services facilitates partnerships with local health care providers to support student health care and prevention throughout the district. Our department also works closely with internal and external health and behavioral health care providers to promote a healthy learning environment.

health Services Programs

School Health

Asthma Forms

State of LA Medication Order Form
State of LA Authorization for Release of Medical Information
School Asthma Management Program Enrollment Forms 2018-2019
HCS Asthma Action Medical Plan for School – English
HCS Asthma Action Medical Plan for School – Spanish
EBR Parent Consent for Medication at School

Diabetes Forms

Diabetes Medical Management Plan for School
EBR Parent Consent for Medication at School
EBRPSS Specials Diets Prescription Order Form
State of LA Medication Order Form
State of LA Health Info Form for Parents

Anaphylaxis/Allergies Forms

EBRPSS Lactose Free Milk Request
EBR Parent Consent for Meds at School
EBRPSS Special Diets Prescription Order Form
HCS Anaphylaxis Emergency Allergy Medical Plan for School
State of LA Authorization for Release of Medical Information
State of LA Annual Health Information Form for Parents
State of LA School Med Order Form for Prescribers

Dietary Restrictions/Considerations Forms

Lactose Free Milk Request 2019-2020
Procedures for Special Diets Religious Reasons 2019-2020
Special diet Religious Request Form 2019-2020
EBRPSS Specials Diets Prescription Order Form

Tracheostomy Forms

State of Louisiana Medication Order
EBR Parish Schools Parent Consent for Medication at School
State of Louisiana Authorization for Release of Medical Info
Tracheostomy “Go Bag” School Supply List
Authorization for Tracheostomy Care in the School Setting

Special Health Care Needs Forms

EBR Parent  Consent for Meds at School
Med History Update Form Doctor Signature Required
State of LA Authorization for Release of Medical Information
State of LA Health Info form for Parents
State of LA Medication Order Form
Physician Parent Authorization for Special Needs
Authorization for Tube Feeding in the School Setting
Authorization for Urinary Catheterization in the School Setting

Medication Administration Forms

EBR Parent Consent for Meds at School
State of LA Authorization for Release of Medical Information
State of LA Health Information Form for Parents
State of LA Medication Order Form

Student Athlete Forms

State of Louisiana Authorization for Release of Medical Information
State of Louisiana LHSAA Student Athlete Health Exam Evaluation

Seizures Forms

EBR Parent Consent for Meds at School
Physician Order for Diastat Administration at School
Seizure Action Plan Provider signature Requirements
State of LA Authorization for Release of Medical Information
State of LA Health Information Form for Parents
State of LA Medication Order Form
Physician Parent Authorization for Special Needs

Immunizations Forms

EBRPSS Immunization Policy
Statement of Exemption Immunization Requirement – English
Statement of Exemption Immunization Requirement – Spanish
Statement of Exemption Immunization Requirement – Vietnamese
Statement of Exemption Immunization Requirement – Arabic
Statement of Exemption Immunization Requirement – Mandarin

Health Centers in Schools (HCS)

Our Lady of the Lake Children’s Health Centers in Schools provides comprehensive health services and wellness education to students in grades K-12 in East Baton Rouge (EBR) Parish School System, operating 7 full-service clinics and providing school nursing services to students across the school district. The services provided include qualified and dedicated school nurses, health educators, health screenings (including annual vision and hearing screenings), health plans for students with chronic/acute health conditions, and daily management of student health needs in the school setting.

Click here for more information about Health Centers in Schools

Click here for more information about COVID-19 Vaccines for Teens

Health Center Consent Forms

Health Center Consent Form
Health Center consent Form Flyer
Health Clinic HIPAA Form

COVID-19