If a medication administration form (school form) needs to be completed to start the 2022-2023 school year, plan ahead and obtain these forms online or from the school office. We are happy to help you get your school paperwork completed! This also applies to forms needed for summer camps.

Please be aware that we will be completing forms in the order they are received and as quickly as is possible. If there is a sudden increase in volume of forms to complete, there may be delays. The sooner the forms are submitted, the better. You can submit your forms by dropping them off, mailing them in, sending via portal message or fax (616-949-3531). Submit your forms this summer to avoid starting the school year without the proper forms.

When submitting forms, please include a current weight, names of specific medications you want your student to have at school, and whether they can carry these medications in their backpack and/or self-administer. Please complete designated parent/child sections of form and sign if indicated. An appointment with a Grand Rapids Allergy provider in the last year is required to have forms completed, otherwise they will be completed after an appointment is kept. Click here to request an appointment.

Please call the office with any questions.

In Summary:

Requirements for Form Completion

• Appointment in the last 12 months
• Current weight
• Notation of which medications are needed
• Notation if student can carry/administer medications
• Parent/student completion of designated sections

How to Submit

• Patient Portal
• Drop off/mail in
  • 970 Parchment Dr SE, Grand Rapids, MI 49546
• Fax
  • 616-949-3531

What We Do

• Complete in order received, attaching applicable action plans
• Fax to the school/camp
• Completed form attached to electronic medical record