School and Medical Forms

Elim strives to ensure the health and safety of each person entrusted to our care.

We are committed to promoting the health, safety and security of our staff, our students, and those who depend upon our services. Below you will find relevant forms that we may need to ensure the safety and health of your loved ones. Contact the nursing office at

School Forms

Classroom Observation Request

Classroom Observation Confidentiality Agreement

Classroom Observation Confidentiality Agreement Spanish

Release of Information

Release of Information Spanish

Consent for Private Transportation of a Student

Consent for Reimbursement

Video Consent Form

Video Consent Form Spanish

Recording of Virtual Meetings Consent Form

Medical Forms

Return to School

Field Trip Plan Special Medical Needs

Dental Exam Form

Physical Exam and Immunization Form

Prescription Medication Order

Physical Therapy Perscription

Occupational Therapy Perscription

Seizure Action Plan

Special Diet Order

Non-discrimination Policy:
It is the Standard of Elim Christian Services to admit children and adults to agency services regardless of race, color, national and ethnic origin, to all the rights, privileges, programs, and activities generally accorded or made available to agency service recipients. Elim Christian Services does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered policies. Read Full Disclosure.