ESU 8 Health Card (sides 1 and 2) 

ESU 8 Physical Form (sides 1 and 2)

ESU 8 Hearing Screening Record

ESU 8 Classroom Hearing Survey

Hearing Screening Letter – Referral

Hearing Screening Letter – No Referral

High Frequency Hearing Loss Letter

Vision Referral Form

Dental Referral Form

Asthma/Anaphylaxis Self Management Form

Diabetes Self Management Form

Sample Diabetes 504 Plan

TransACT translated documents

Nebraska DHHS Health Forms

DHHS Certification of Physical Examination Form

DHHS Waiver of Physical Examination and Visual Evaluation Form

Report of Visual Evaluation

Sample Medication Authorization Forms:

  1. Sample Medication Authorization Form 1
  2. Sample Medication Authorization Form 2
  3. Sample Medication Authorization Form 3

Medication Log and Count Form

Medication Error Form

Documentation of Medication Administration Competency

ESU8 Documentation of Medication Administration Competency