Students Emergency Card


For the Emergency Card, please click here(please use the fillable format)

For the protection of a student’s health and welfare, the Mt. Diablo Board of Education requires the parent or guardian to keep emergency information current at the school of attendance.  This information includes the home address and telephone number, business address and telephone number of the parent or guardian, and the name, address and telephone numbers of a relative or friend who is authorized to care for the student in an emergency situation if the parent or legal guardian cannot be reached. (E.C. 49408)

Parents are advised that an ambulance may be requested if site personnel believe an injury or sickness to a student is serious or life threatening.  The district is not responsible for ambulance charges in such cases.
This information is found in the MDUSD Parent Handbook.


For the Authorization to Administer Medication at School card, please click here.

If your student needs to take medication while at school, either prescription or over-the-counter, we need an Authorization to Administer Medication at School  —  signed by your student’s physician, parent, and principal (or NHS designee) —  filed in the Northgate Attendance Office.

A new form is needed every year for each medication.

Medicine must be in original container with student’s name, method of administration, dosage, frequency, etc.

ALL medication must be picked up at the end of each school year…the Attendance Office or District Nurse will discard any remaining in the office.

Questions can be directed to the Northgate Attendance Office 938-0900 ext 3505, 7:30am-3:00pm