Forms

The following forms MUST be printed out and completed by a Health Practitioner Add: (Note:All forms are in PDF format.)

• Health Inventory MD (Required): https://earlychildhood.marylandpublicschools.org/system/files/filedepot/3/occ1215-healthinventory.pdf
• Immunization Certificate (Required): https://earlychildhood.marylandpublicschools.org/system/files/filedepot/3/maryland_immunization_certification_form_dhmh_896_-_february_2014.pdf
• Blood Lead Testing Certificate (Required): https://earlychildhood.marylandpublicschools.org/system/files/filedepot/3/dhmh_4620_bloodleadtestingcertificate_2016.pdf
• Asthma Action Plan and Medication Administration Form:(Only if applicable) https://earlychildhood.marylandpublicschools.org/system/files/filedepot/3/occ1216a-seizuremedicationadministrationauthorizationform.pdf
• Allergy and Anaphylaxis Medication Administration Authorization Form (Only if applicable): https://earlychildhood.marylandpublicschools.org/system/files/filedepot/3/occ_1216b-medicationincidentreportingform.pdf
• Seizure/Convulsion/Epilepsy Disorder Medication Administration Form (Only if applicable):  https://earlychildhood.marylandpublicschools.org/system/files/filedepot/3/occ_1216c_seizure_emergency_medication_form_may_2022_final.pdf
• Medication Authorization Form (MD) (Only if applicable; This form should NOT BE USED FOR MEDICATIONS TO TREAT allergy, anaphylaxis, asthma seizure, convulsions, epilepsy disorder-see above for appropriate form for any of these disorders): https://earlychildhood.marylandpublicschools.org/system/files/filedepot/3/occ1216-medicationadministrationauthorization.pdf 
• Topical Base Care Product Application Authorization Form (for applying diaper cream, sunscreen or insect repellent): https://earlychildhood.marylandpublicschools.org/system/files/filedepot/3/occ_1216e_-_topical_product_application_approval.september_2022.pdf

Online Forms: Emergency, Intake and Authorization Information are required, and MUST be filled out online (See link to Guidestar Online Parent Portal below)

To complete online forms, click on link to Guidestar Online Forms Parent Portal: https://fs30.formsite.com/Guidestar01/ClaraBartonCenter/form_login.html