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Health Forms

Parent/Guardian Health Forms

Allergy Action Plan Form (PDF)

Asthma Action Plan Form (PDF)

Cardiac Care Plan Form (PDF)

Emergency Medical Authorization Form (PDF)

Food Allergy Action Plan Form (PDF)

HIPPA - Mutual Exchange of Information (PDF)

Medication Authorization Order Form (PDF)

Michigan Inhaler Law Fact Sheet (PDF)

Seizure Action Plan Form (PDF)

Staff Health Forms

Allergy Action Plan Form (PDF)

Asthma Action Plan Form (PDF)

Bloodborne Pathogen Exposure Control Plan (Google Link)

Cardiac Care Plan Form (PDF)

Concussion Awareness Information (PDF)

Diabetes Monitoring Log (PDF)

Emergency Medical Authorization Form (PDF)

Emergency Medication Bus Transportation Form (PDF)

Fax Sheet Form (PDF)

Food Allergy Action Plan Form (PDF)

HIPPA - Mutual Exchange of Information (PDF)

Naloxone (Narcan) - Report of Administration

Medical Incident Report Form (PDF)

Medication Administration Log Form (PDF)

Medication Authorization Order Form (PDF)

Michigan Inhaler Law Fact Sheet (PDF)

Occasional Medication Transport Form (PDF)

Seizure Action Plan Form (PDF)

Seizure Observation Form (PDF)

Transportation Health Forms

Emergency Medication Bus Transportation Form (PDF)

Find Us

Mount Pleasant Public Schools720 N. KinneyMt. Pleasant, MI 48858Phone: 989-775-2300Fax: 989-775-2309

Schools

  • Mount Pleasant Public Schools
  • Mount Pleasant High School
  • Mount Pleasant Middle School
  • Fancher Elementary
  • Vowles Elementary
  • Ganiard Elementary
  • Pullen Elementary
  • McGuire Elementary
  • Adult Education
  • Oasis
  • Mount Pleasant Athletics
  • GI-TEC Mt. Pleasant

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The District does not discriminate on the basis of race, color, national origin, ethnicity, religion, sex (including gender identity or expression, sexual orientation, pregnancy, childbirth, or a related condition), age, height, weight, familial status, marital status, military service, veteran status, genetic information, disability, or any other legally protected basis, and prohibits unlawful discrimination, including harassment and retaliation, in any education program or activity that it operates, including in admission and employment.

Inquiries about unlawful discrimination, including unlawful harassment and retaliation, may be referred to the District’s applicable Coordinator and/or an agency with jurisdiction, such as the U.S. Department of Education’s Office for Civil Rights, the Michigan Department of Civil Rights, the Equal Employment Opportunity Commission, or the Department of Justice.

Designated Title IX Coordinator, Designated Section 504 Coordinator and Designated Civil Rights Coordinator/Employment Compliance Officer: Linda Boyd, Assistant Superintendent, 720 N Kinney Avenue, Mt Pleasant, MI 48858, (989) 775-2303, lboyd@mp.edzone.net

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