Skip to main content
Ithaca Schools - click for home 
Ithaca City Schools - click for home
 

QUICK LINK
COVID-19 Screenings, Testing, and Contact Tracing
ICSD COVID-19 Surveillance Testing Program
NYS COVID-19 School Report Card Dashboard
Reopen ICSD Updates and Announcements
School Meals Information
Welcoming Remote Students and Staff Back
 
 

Health Services Forms for Parents and Guardians

Medical Request for Alternative Educational Plan (AEP)
At times, students may have barriers to their education due to medical or mental health issues. These may initially be identified by students, their families, teachers, or other educational staff. If appropriate, individual “alternative educational plans” (AEPs) will be created for students in order to help reduce the barriers to their education in school. Learn more about AEPs>>
 
Parent/Guardian Authorization of Another Adult for Administration of Medication
Through this form, parents/guardians can authorize another adult (such as a friend, family member, or household member) to administer certain medications to their child. 
 
Standard Authorization for the Exchange of Health Information
This form authorizes the exchange of protected health information (PHI) and education records (including personally identifiable information obtained therefrom) between your child’s health care provider and authorized school officials.