Confirmation of Registration

If you were not able to come in during the designated week of Confirmation of Registration, please call the office as soon as possible  to set up a time to come in to confirm your registration.

Before coming to meet with Mrs. Dwyer, you will need to complete some additional forms.   These forms are listed below on a series of buttons.  Read the information above each button carefully.  Some forms need a Physician's signature, some need to be notarized.  Click on a button to open or download a form.   You may print the blank form and fill it in by hand or, if the form is a fillable document, you may complete it on your computer.   Please bring your completed forms with you.  

EACH FORM BUTTON HAS INFORMATION ABOVE IT THAT INDICATES WHICH STUDENTS NEED IT.  IF YOU ARE STILL NOT SURE IF YOU NEED A PARTICULAR FORM, PLEASE CALL THE OFFICE (813-935-0232).

THESE THREE (3) FORMS ARE REQUIRED FOR ALL STUDENTS:

YOU WILL NEED ONE (1) PRESCRIPTION MEDICATION AUTHORIZATION FORM FOR EACH PRESCRIPTION MEDICATION TO BE ADMINISTERED AT SCHOOL, INCLUDING AN INHALER. 

THE PRESCRIBING DOCTOR'S SIGNATURE IS REQUIRED ON EACH PRESCRIPTION MEDICATION AUTHORIZATION FORM.  

THIS FORM IS ONLY FOR STUDENTS WITH SEVERE ALLERGIES WHO WILL KEEP AN EPI-PEN IN THE OFFICE:

IMPORTANT:   IT MUST BE FILLED OUT AND SIGNED BY THE CHILD’S PHYSICIAN.

PLEASE PROVIDE THE OFFICE STAFF WITH YOUR CHILD'S EMERGENCY CARE PLAN.

THIS FORM IS ONLY FOR DIABETIC STUDENTS:

IMPORTANT:  IT MUST BE NOTARIZED.

PLEASE PROVIDE THE OFFICE STAFF WITH YOUR CHILD'S DIABETIC TREATMENT PLAN.

this form is only For students who plan to attend the extended day program (3:00PM - 6:00PM)