Port Charlotte High School

School Nurse

Glenn Capo

941-255-7485 Ext.7672

Medication/Treatment Forms

Medication Treatment Authorization Form
Medication form that needs to be filled out by a health care provider in order to have medication at school. Please read the instructions/requirements section.
ALLERGY Medication Treatment Authorization Form
Allergy medication form that needs to be filled out by a health care provider in order to have medication at school. Please read the instructions/requirements section.
DIASTAT Medication Treatment Authorization Form
Medication form that needs to be filled out by a health care provider in order to have the medication at school
Diabetes Medical Management Plan
Medication form that needs to be filled out by a health care provider in order to assist student in managing their diabetes at school.
Authorization for Orthopedic Injury/Assistive Device Form

School Entry Requirements

Florida School Entry Physical Exam Form

Link Library
Charlotte County Health Department Website

Clinic