Forms

Student Health Forms

There are many and varied medical conditions that require specific handling such as asthma, allergies, anaphylaxis, heart conditions or epilepsy. Children with special health needs that require specific handling will require a health management plan. Forms are available for your Doctor to complete. The medical advice is used by school staff to create a health management plan in consultation with the parent or carer. Health Plans with a photo of your child are displayed in the medical room, staff room, offices and other staff work areas. The school arranges training for staff as required.

Student Health Care Summary

Asthma Action Plan

Anaphylaxis Action Plan - EpiPen

Anaphylaxis Action Plan - Generic

Epilepsy Seizure Management Plan - 1 Seizure Type

Epilepsy Seizure Management Plan - 2 Seizure Types

Diabetes Management Plan - Multiple Injections and CGM

Additional Enrolment Forms

Here you can find all relevant forms for parents and caregivers. Click on each tab for the relevant form. Completed forms can be delivered via: email mounthelena.ps@education.wa.edu.au; postage Lot289a Keane Street East, Mount Helena WA 6082 or in person to the front office.

Media Consent Form

Mobile Phone Permission

Advertising Permission for Marketing Purposes

MHPS Third Party Service Consent Form