Health and Medical Information

Holly Area Schools’ Medical Care Plan is a district-wide measure to assist the District in providing care to students with a chronic medical condition, as directed by each student’s authorized medical provider.  The Medical Care Plan consists of a Medical Action Plan form and may include a Physician’s Authorization for Medication at school.

Students with a chronic medical condition that requires treatment at school, will be required to have a current Medical Care Plan on file in the school office.  The Medical Care Plan will need to be updated each school year and with any medication or medical care changes. If your student has a food allergy or sensitivity, MDE the food service form must also be filled out and signed by a physician for our food service department.

Students who require only the administration of medication during the school day, will need to have a Physician’s Authorization for Medication filled out. Form must be signed by the parent and physician, and on file in the school office before medication can be given. This form is for both prescription medications and any over the counter oral medication. If your student requires an over the counter medication that is not taken by mouth, please contact the schools’ main office.

Medication should be in the original labeled container. Medication to be given must match the label with the student's name. All over the counter medication must be in a brand new, unopened bottle or container.  

It is the parent/guardian responsibility to: replace expired medication (no expired medication will be given); provide refills in the new original container when needed; transport medication to and from the school office; and pick it up at the end of the school year. The school does not store medicine over the summer. Any medication left in the office at the end of the school year will be disposed of by the district nurse.

If an emergency arises before receipt of student-specific medical interventions, treatments or medications, the school district policy and basic first aid procedures will be followed, 911 will be called, if deemed necessary.

*Attention parents of students with seizures….Please read the following *
Please speak with your authorized medical provider about prescribing a rescue medication that will provide the safest, fastest and most effective treatment while maintaining your student’s dignity and privacy.

If you have any questions please contact the school office.

Holly High School:  248-328-3200
Holly Middle School:  248-328-3400
Davisburg Elementary:  248-328-3500
Holly Elementary:  248-328-3600
Patterson Elementary:  248-328-3700
Rose Pioneer Elementary:  248-328-3800

Please note:  Holly Area Schools is not a medical facility. To the extent practicable and safe for the student, medication should be administered during non-school hours.

Medical Forms

Authorization (Parent and Physician) for Prescription Medication Administration
Contract for Self Carry
Discontinued Treatment
Food Sensitivities and Intolerances
Medical Care Plan - Asthma
Medical Care Plan - Diabetes
Medical Care Plan - General
Medical Care Plan - Respiratory
Medical Care Plan - Seizure
Medical Care Plan - Severe Allergy
Medical Care Plan - Urinary
Tube Feeding Order Form

MDE Food Service Special Accommodations/Food Substitution Information
Note:  Pages to be completed are included with the Food Sensitivities/Intolerances and Severe Allergy form links above

Homebound and Hospitalized Students

Holly Area Schools students who are unable to attend school because of medical conditions may be eligible for Homebound or Hospital teaching programs. Eligibility is based on a physician's written certification that a student has a medical condition that prevents him/her from attending school.

Referrals should be initiated at the earliest possible time to prevent unnecessary delays in a student's education. For more information, please visit our Homebound and Hospitalized Services page.