Brief Intervention Youth Surveys Child Welfare Attendance (CWA) Community Based Organizations Consent and Authorization Coordinated Program Monitoring (CPM) Tool Counseling Center Counseling Internship Program Dental Program ExCEL After School Programs Families & Youth in Transition Program Foster Youth Services Health Advocate Health Education Health Education Teacher Leader Health Promotion Committee Healthy School Team Learning Support Professional Medication and Emergency Care Plans

Notification Letters Nutrition Education Program Office of School/Family Partnership Parent/Family Outreach Professional Development (PD) School District Nurse Section 504 SSSD Staff Forms SFUSD Human Resources Student Assistance Program Student Intervention Team Student Mentor Program Student Success Team Student Transition Program Translation Department TUPE Tobacco Youth Surveys Work Permits

Brief Intervention Youth Surveys

• BIS Worksheets and Handouts (pdf)

 

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Child Welfare Attendance (CWA)

• For Child Welfare and Attendance forms and resources, please visit the following links.
  Counseling Conference | Expulsion Hearings | Safety Transfer | Student Attendance Review Board (SARB)

 

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Consent and Authorization

• Authorization to Release Confidential Information (MS Word File)
• Authorization to Release Confidential Information:  English (doc), Chinese (pdf), Spanish (pdf)
• SFUSD Counseling Consent Form with Survey: English, Chinese, Spanish (pdf)
• Oath of Confidentiality (MS Word File)
• Screening and Assessment Section of Release Form (MS Word File)

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Coordinated Program Monitoring (CPM) Tool

• Elementary School CPM (doc)
• Middle School CPM (doc)
• High School CPM (doc)

 

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Counselor

• AB 1802 Directive (doc)
• AB 1802 Academic Review HS (doc)
• AB 1802 Academic Review MS (doc)
• AB 1802 Conference Tracking for school site (doc)

 

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Health Education

• Curriculum (MS Word File)
• Policies (MS Word File)

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Health Education Teacher Leader

• Job Description & Application

 

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Healthy School Team (MS Word Files)

• Activity Log (link)
• Middle School Foster Youth Services
  Job Description
• Middle School Health Liaison
  Job Description
• Middle School LGBTQ Support Liaison
  Job Description
• Middle School Physical Activities_Positive Alternatives
  Job Description
• Site Agenda Meeting Notes

 

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Medication and Emergency Care Plans

• Care plan flow chart (pdf)
• Consent Form (pdf)
• Emergency Card Care Plan & Parent Letter (pdf)
  English, Chinese, Russian, Spanish, Tagalog, Vietnamese
• Emergency Care Plans
  Generic: English, Chinese, Spanish (pdf)
  Allergy: English, Chinese, Spanish (pdf)
  Asthma: English, Chinese, Spanish (pdf)
  Diabetes: English, Chinese, Spanish (pdf)
  Seizure: English, Chinese, Spanish (pdf)
• Head Lice
  SFUSD Head Lice Procedure (pdf)
  A Parent’s Guide to Head Lice: English, Chinese, Spanish (pdf)
  Guidelines for Parents to Control Head Lice:  English, Chinese, Spanish (pdf)
  Parent Notification Letter:  English, Chinese, Spanish (pdf)
  Exclusion Letter: English, Chinese, Spanish (pdf)
  
• H1N1
  H1N1 Preparation and School Readiness WAD (pdf)
  Frequently Asked Questions about H1N1 for SFUSD Administrators and Staff (doc)
  Is Your School Prepared for H1N1 Checklist (doc)
  Flu Season Tips for Parents English Chinese Spanish
  Parent/Guardian Letter : English | Chinese | Spanish (pdf)
  Staff Letter for Flu (pdf)
  Phone Script for H1N1 (doc)
  Influenza Surveillance (doc)
• Medication Form
  English, Chinese, Spanish (pdf)
• Medical Condition List (MS Excel file)
• Nurse Referral Form (MS Word file)
• Student Emergency-Medical Information Card (pdf)
  English, Chinese, Spanish
• Student Emergency-Medical Information Card Processing Procedure (pdf)
• SFUSD School Health Form (doc)
• SFUSD Athletics Preparticipation Physical Examination Form (pdf)

 

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Notification Letters (pdf)

• Elementary School Parent Notification Letters
  English, Spanish, Chinese, Tagalog, Vietnamese, Russian
• Middle School Parent Notification Letters
  English, Spanish, Chinese, Tagalog, Vietnamese, Russian
• High School Parent Notification Letters
  
  
  • Health Education Notification Letters
    English, Chinese, Spanish
  • SFUSD Condom Availability Programs
    English, Chinese, Spanish

 

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Parent/Family Outreach

• A Guide to Team Home Visits
• Home Visit Documentation Form
  English | Chinese | Spanish
• Home Visit Notice
  English | Chinese | Spanish

 

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Professional Development (PD)

• SSSD PD Evaluation Template (doc)

 

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School District Nurse

• Please visit the Monthly Log Website (link)
• Nurses SharePoint Site (link)
• Standard Daily Nurse Log Template (xls)
  *Provided by ETR as a template, however, customizing this template if needed is highly encouraged.*
• Sample Daily Nurse Log Templates
  • Elementary Sample #1 (xls)
  • Elementary Sample #2 (xls)
  • High School Sample#1 (xls)
    
    

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SSSD Human Resources

• Forms relating to Human Resources can be found here.
• Functions of Payroll and HR (MS Word file)

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SSSD Staff Forms (MS Word Files)

• Business Card Request
• Certificated Timesheet
• Classified Timesheet - Daily Time Report (Itinerant Staff)
• Classified Timesheet (Central Staff)
• Monthly Calendar (blank)
• Time Off Request
• Mileage/Expense Report (.xls)
• Mileage Reference from 20 Cook (.xls)
• Request for Reimbursement (.xls)
• Request for Purchase
• Request for Funding Source (K Resos, Stipends, Subs)
• Staff Emergency Card

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Student Assistance Program

• What is a SAP? (pdf)
• SAP Action Plan (doc)
• SAP Best Practices Checklist (pdf)
• SAP Flowchart (pdf)
• Parent Teacher Conference Form (doc)
  
  

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Student Success Team (pdf)

• Child Development Program SST Forms (doc)
• Menu Of Interventions 11-01
• SFUSD Language Survey
• SFUSD Student Referal for Assessment
  English | Chinese
• Speech and Language Checklist
• SST Best Practices
• SST Brochure
  Chinese | English | Russian | Spanish | Tagalog
• SST Classroom Form
• SST Developmental History (4.0)
  English | Spanish | Tagalog | Chinese
• SST Facilitator Self-Assesment Checklist
• SST Flowchart
• SST Log (5.0)
• SST Manual
• SST Observation of Learning Environment (3.0)
• SST Parent Notification Letter
  English | Chinese | Spanish
• SST Request for Assistance K-12 (1.0)
• SST Summary Form for First Meeting (2.0)
  English | Chinese | Spanish
• SST Summary Form for Follow-up Meetings (2.0a)
  English | Chinese | Spanish
• SST Teacher Input - Secondary (2.1)
• Teacher Preparation Checklist for SST Meeting

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TUPE Tobacco Youth Surveys

• Awarness Post Survey 09-10 (pdf)
• Peer Education Survey (pdf)
• Quit PreSurvey 09-10 (pdf)
• Quit Post Survey 09-10 (pdf)

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