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Bridgeport School District

To Build and Sustain a Legacy of Lifelong Learning!
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Health Services Forms:

Agreement for Self-Administration of Asthma and Anaphylaxis Meds

Asthma Information for School

Asthma Medication Authorization and Treatment Plan

Authorization for Release of Records

Bee or Insect Allergy Information for School

Bridgeport- Seizure Care plan - with medication orders

Dietary Accommodation

Food Allergy Information for School

Heart Condition Information for School

History Questionnaire for Student w Diabetes

School Emergency Asthma Plan

Seizure Action Plan

Seizure Information for School

Student Health History

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Bridgeport School District1400 Tacoma AveBridgeport, WA 98813(509) 686-5656(509) 686-2221

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Bridgeport School District No. 75 is an Equal Opportunity Employer who fully and actively supports equal access to all programs and activities for all people without discrimination based on race, religion, creed, color, national origin, age, honorably-discharged veteran or military status, sex, sexual orientation, gender expression or identity, marital status, the presence of any sensory, mental or physical disability, or the use of a trained dog guide or service animal by a person with a disability. The district will provide equal access to school facilities to the Boy Scouts of America and all other designated youth groups listed in Title 36 of the United States code as a patriotic society. District programs will be free from sexual harassment. Auxiliary aids and services will be provided upon request to individuals with disabilities. Inquiries regarding compliance and/or grievance procedures may be directed to the school district’s Title lX/RCW 28A.640 compliance officer and/or Section 504/ADA coordinator, Hanna Coffman at hcoffman@bsd75.org, PO Box 1060, 1400 Tacoma Avenue, Bridgeport, WA. 98813, PH: (509) 686-5656, FAX (509) 686-2221.

Click here for the USDA Nondiscrimination Statement

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