School Nurse Report of Designated Personnel to Administer Stock Epinephrine

1 CCR 301-68  6.02 In school districts with a board-adopted policy allowing for the administration of stock epinephrine auto-injectors, the School Nurse must report to the State School Nurse Consultant at the Department of Education whether training and delegation has occurred and, if so, the number of employees in the school or school district that have been trained and delegated to administer epinephrine auto-injectors.
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School Name
School Name
School Name
School Name
School Name
School Name
School Name
School Name
School Name
School Name
 # of Designated Personnel
Number Trained
Number Trained
Number Trained
Number Trained
Number Trained
Number Trained
Number Trained
Number Trained
Number Trained
Number Trained
Colorado Department of Education Educational Data Advisory Committee approval stamp