Student Forms

The forms in the following list are included in the Annual Student Packet. We update this information annually to comply with state and federal guidelines.

If at any time throughout the year, a student’s information needs to be updated, such as a permanent address change or a change in school-administered medication, please print out the appropriate form below and submit it to the office.

 

Emergency Medical Authorization – informs the school of what to do for your child in the event of an emergency (who to call, what doctor or hospital to go to); must be updated when a student’s permanent address is changed

Authorization to Release Student to Person Other That Parent – tells the school who may pick your child up from school (valid ID must be presented when picking a student up from school)

Proof of Residency Compliance Letter and Affidavit – required by the state of Ohio to determine eligibility and certain funding requirements

Authorization for the Administration of Medication – required to give medication to your child in school; a new form must be completed and signed by the physician if a medication is changed (dosage, frequency, name, etc.); the information on the form must match the information on the prescription bottle

Authorization for the Administration of Asthma Inhaler(s) – required for students who may need an asthma inhaler in school

Consent to Photograph or Video Record for Use in Media – permits the school to use a photo or video clip that includes your child in school publications, including the school’s website and social media pages such as Facebook and Twitter

Consent to Photograph or Video Record for Instructional Purposes Only – permits the school to use a photo or video clip that includes your child for classroom instruction only

 

If you are looking for a particular form and it is not listed here,
please contact the school office at 419-897-4400 for further assistance.

To view and print the Student Application, please visit the “Admission” page:
http://www.autismmodelschool.com/parents/admission/