Useful Student Forms

  • For your convenience we have added several useful forms at the bottom of this page in English & Spanish that you can download.


    New Jersey state law requires that all students requiring Asthma medication in school for emergency purposes have a completed Asthma Treatment Plan. (i.e. inhalers or nebulizer treatments)  The plan is completed and signed by your physician and parent/legal guardian and submitted to the health office once a diagnosis is made and at the start of each school year thereafter.

    Food Allergies/Anaphylaxis:

    Children requiring emergency medications in school in the event of allergic reaction should have a completed emergency plan on file.  The form is completed and signed by your physician and legal guardian and submitted to the health office once a diagnosis is made and at the start of every school year thereafter.

    Administration of Medicine Form

    Routine daily medications should be administered at home.  A physician's order and parent consent is required to administer any prescription or over the counter medication at school.  If the medication is required for asthma, please download the Asthma Treatment Plan.  The district Administration of Medicine form should be used for all other medication orders.  Please be sure that your primary care physician signs and stamps all orders. 

    Physical Forms

    All new entrants into the Hackensack School District are required to submit a physical examination within the first 30 days following registration.  The physicals can be found in the registration packet.  Students should have their physical exam completed by their primary care physician.  If a student does not have a medical home or does not have insurance coverage, please see the school nurse to discuss available options.


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