About this Form
Form number: 336-69
Audience: School Staff
Last revised: November 2017
Form 565-1 - Student Emergency Information (Yellow Card)
Form 525-13 - Authorization to Administer Prescribed Medication
Instructions: This form should be completed by members of a student’s Section 504 or Individualized Education Program (IEP) team (parents/guardians, general education teachers, special education teachers, related service providers, school community health nurse/school health room technician, school counselors, and/or pupil personnel workers) to document supports required for students with disabilities to safely participate in meals at school.
Forms require Adobe Acrobat Reader 8 or higher. Get Acrobat