Alabama Safe at Schools
Title
Description
ABN Delegation Roster 2018
Alabama Board of Nursing Delegation Chapter 610-x-7-.10
Delegation Of Insulin And Glucagon Administration in the School Setting
Standardized Form Diabetes Delegation Decision-Making Grid
Individualized Healthcare Plan (IHP) Packet
Student Agreement Form
Tier I sign-in sheet
Tier II sign-in sheet
Tier III sign-in sheet
Glucagon Skill Check Sheet August 2018
Glucagon Emergency Medication Post Test
Glucagon Protocol revised August 2018
Glucagon Provider Competency revised August 2018
Powerpoint Presentation
Powerpoint Presentation
Curriculum and Programs – Adrenal Insufficiency
Title
Description
Safe Schools Adrenal Insufficiency Curriculum
Curriculum and Programs – Seizures
Title
Description
Seizure Curriculum Seizure Training and Medication Administration to Unlicensed Personnel
Act No. 2021-76 Delegation of pre-measured Seizure Medication
Curriculum and Programs – AED Guidelines
Title
Description
Link to the Laws and Policies section
Curriculum and Programs – Anaphylaxis Preparedness
Title
Description
Anaphylaxis Preparedness Guidelines
Anaphylaxis Preparedness Act No 2014-2015
Curriculum and Programs – Diabetes Safe at Schools
Title
Description
Self Administration of Medication Legislation Act No. 2007-463
Diabetic Curriculum revised August 2018
Curriculum and Programs – Naloxone
Title
Description
Naloxone Training Program for Unlicensed Personnel
Curriculum and Programs – Medication Curriculum
Title
Description
ABN Delegation By School Nurses
Amended Medication Curriculum 2018
PDF format Controlled Substance Inventory Form
Unlicensed Medication Assistant Post Test Written Examination (revised March 2018)
Medication Assistant Delegation Form
Medication Assistant sign-in sheet
Prescriber Parent Authorization Form, only for OTC medication
Curriculum and Programs – Scoliosis Manual 2019
Title
Description
Revised 2019 Scoliosis Manual
Forms and Documents
Title
Description
Alabama School Health (2017 Health Record Assessment Form)
Controlled Substance Inventory Form 2024
Delegation Form 2024
ADD/ADHD Individualized Healthcare Plan (IHP) Packet
Anaphylaxis Individualized Healthcare Plan (IHP) Packet
Asthma Individualized Healthcare Plan (IHP) Packet
General Individualized Healthcare Plan (IHP) Packet
Headache Individualized Healthcare Plan (IHP) Packet
Seizure Individualized Healthcare Plan (IHP) Packet
Medication Administration Record (MAR)
Prescriber Parent Authorization Form 2024
Prescriber Parent Authorization Over the Counter Medication 2024
Self Administration and / or Keep on Person Documentation 2017 (Including parent / guardian signature)
Health Information
Title
Description
Flu Information
Standard Precautions
Powerpoint for Standard Precautions (Basic sample)
Exam for Standard Precautions (A sample, per request)
Pandemic Flu Preparation Guidance
Alabama Department of Public Health Division of Disease Control Administrative Code Chapter 420-4-1 Notifiable Disease
Link to ADPH Immunizations
Immunizations
Title
Description
Meningococcal Disease and Vaccine Flyer
Meningococcal Information / Jessica Elkins Law Act 2014-274
Link to U.S. Department of Education Laws and Guidance, Education of Homeless Children and Youth
Laws and Policies
Title
Description
AED Act 2015-161
AED Act 2009-754
AED Act 99-370
Autism
Backpack Act 2017-19
Concussion Law
Immunization Law
Influenza Act 2017-368
Alabama State Board of Health, Alabama Department of Public Health Division of Disease Control, Administrative Code Chapter 420-4-1 Notifiable Diseases
Self Administration of Medications Act 2007-463 HB 423
Sunscreen Act 2017-278
Dept. of Public Safety Legislative Authority
Drivers License Act related to school behavior.
Dept. of Public Safety form for use when students leave school before graduating.
Seclusion and Restraint Administrative Code procedures
Resources and Links
Title
Description
PDF, LEA Sample: AED Monthly Checklist
PDF, LEA Sample: Nurse Monitoring Check Sheet
PDF, LEA Sample: Nurse Monitoring Form
PDF, LEA Sample: School Nurse Evaluation Form
PDF, LEA Sample: Timeline and Checklist for Health Services