Roseville City School District
Overview

Medication Forms

Medications At School

A student who requires medication during the course of the school day must have written permission from both his/her parent or guardian and physician, detailing the medication, method of administration, amount, and time it is to be given.

Parents/Guardians must bring the medication to the school office in its original container, with the correct dosage, administration information, and student’s name printed on the label.

A new medication form must be completed each school year.

Medication forms can be accessed for each school site (see links below). All medication forms are also available in the school office.

Mandated Health Screenings

Per California State Law, school nurses coordinate mandated screenings for the following grade levels:

  • Vision K, 2, 5, 8
  • Hearing K, 2, 5, 8
  • Color Vision K boys only

If your child does not pass one of the above screenings, a referral will be sent home.

Physical Health Examination (CHDP) Requirement

To protect the health of children, California law requires that students receive a health assessment within 18 months prior to a student beginning their first grade year. Roseville City School District requires that this is completed in the Kindergarten year. Please complete the health exam report (below) with a health examiner and return it to the school. 

Health Examination for School Entry - English/Spanish

WAIVER of Health Examination for School Entry - English/Spanish

Oral Health Form

Effective January 1, 2007, students in their first year of a public school must submit proof of oral health assessments. The assessments must be performed by a licensed or registered dental health professional, and proof of assessment is due on an annual basis by May 31.

Oral Health Assessment - English
Formulario de evaluación de la salud bucal - Español

Titlesort icon Type Attachment
Blue Oaks Elementary Medication Form
Blue Oaks Medication Form
Brown Elementary Medication Form
Brown Medication Form
Buljan Middle Medication Form
Buljan Medication Form
Chilton Middle Medication Form
Chilton Medication Form
Cirby Elementary Medication Form
Cirby Medication Form
Cooley Middle Medication Form
Cooley Medication Form
Crestmont Elementary Medication Form
Crestmont Medication Form
Diamond Creek Elementary Medication Form
Diamond Creek Medication Form
Eich Middle Medication Form
Eich Medication Form
Fiddyment Farm Elementary Medication Form
Fiddyment Farm Medication Form
Gates Elementary Medication Form
Gates Medication Form
Junction Elementary Medication Form
Junction Medication Form
Kaseberg Elementary Medication Form
Kaseberg Medication Form
Orchard Ranch Elementary Medication Form
Orchard Ranch Medication Form
Riego Creek Elementary Medication Form
Riego Creek Medication Form
Sargeant Elementary Medication Form
Sargeant Medication Form
Spanger Elementary Medication Form
Spanger Medication Form
Stoneridge Elementary Medication Form
Stoneridge Medication Form
Thomas Jefferson Elementary Medication Form
Thomas Jefferson Medication Form
Woodbridge Elementary Medication Form
Woodbridge Medication Form