Physician Resources
Updated School Forms
The Hawaii Department of Education, School Health Section, has released new medication forms. These forms can be downloaded below or from this HIDOE website.
The main highlights are the following:
DOE will no longer require medications to be labeled with the words "FOR SCHOOL USE"
We recognize the disruptions and frustration the past policy caused. Schools will still screen medication containers for the "5-Rights" of medication administration, and labeling requirements are essentially that a pharmacist has dispensed and labeled the medication per state law. It may help for providers to recommend that families request pharmacists to provide a duplicate labeled container when dispensing medications to be kept at home AND at school.
The "SH36" (for all non-diabetes medication orders) now contains 2 pages for provider orders:
Page 3 of the form has standardized asthma, anaphylaxis and seizure rescue order sets for clarity and alignment with standard training for these most common medications.
Page 4 of the form includes space for daily medications, and any emergency medications not covered on page 3. Any provider interest in customizing the standardized orders from page 3 may use page 4 as an alternative.
Please note that the form can be "complete" without submitting a blank page. In other words, if page 3 or 4 is not used then you can save the paper and submit the completed pages only. Page 1 completed by the parent/guardian is always required.
The "SH36DM" (related to diabetes care only) now includes the self-management options which previously required a separate form.
Please also note that DM care options are more detailed than previously, offering more flexibility for individualized care.
The added self-management features provide a "transition" option for adult supervision of children beginning to take responsibility for their own management.
The "Student Self-Administration Authorization" form is a standalone form to allow self-carry and self-administration of asthma inhalers, epinephrine auto-injectors, or glucagon.
This is simply a face-lift of the previous form. As noted above, diabetes self-management was moved to the SH36DM.
Please note the scope of this form is limited to what the legislature has established in state law. No other medications are currently included.
Also of importance, glucagon self-carry requires the authorization to self-administer in state law. No students should be solely responsible for administration of glucagon, though this allows the medication to stay with the child.
The "Volunteer Authorization" form is intended to accompany any orders for epinephrine (SH36 page 3) or glucagon (SH36DM).
While this is not a requirement of providers, schools benefit from this authorization to make the most of resources they have to meet student's health needs.
The form can be completed separately from the SH36/SH36DM, so schools may request the Volunteer Authorization form after receiving the orders on a SH36/SH36DM.
As previously, each form's requirements and related policies are covered on the form itself (see under heading "NOTICE TO PARENTS/LEGAL GUARDIANS AND HEALTHCARE PROVIDERS"). We do ask that providers read and be familiar with these details.
Please be assured that schools will not be required to refuse outdated forms at this time. At some point after the start of the coming 2024-2025 school year, HIDOE will stop accepting the old form versions.