Skip Navigation

Medication Forms and Policies

Student Medication Forms

 
Medication Drop Off Sign Up | Thursday, July 23 or Tuesday, August 4 


Student Medication Policy: 

  • Students are not allowed to have any medication, prescription or non-prescription, in their possession at any time on the school grounds.
  • If medication must be administered at school on a regular basis, a Parental Consent Form for Medication Administration for each medication must be completed and signed by the parent and the physician. The physician’s portion of the form must include the child’s name, diagnosis, name of the medication, time/frequency to be administered at school, dosage and length of time to be administered. This form must accompany the medication.
  • Prescribed medication must be in an updated container that meets acceptable pharmaceutical standards. The label must include the name of the student to be administered medication, name of medication, strength, and amount and time it is to be administered.
  • A new physician’s order is needed at the beginning of each school year. Verbal phone orders from physicians or parents cannot be accepted.
     

Prior to bringing medication to the school for medication drop off:

  • Review paperwork to ensure all sections, including the photo and signatures, are completed.
  • Medication and all completed forms must be submitted together in a labeled ziplock bag to be accepted.
  • Visit the student's health and emergency form in FACTS Parent Portal to reflect the medication to be administered.
  • If your child requires medication during the school day, the same medication must be provided for Before and After Care. Please bring the additional medication during the initial medication drop off. This additional medication must be provided before your child may attend school and/or Before and After Care.
     

FOOD ALLERGY CHECKLIST: 

  1. Diet Prescription (Allergy) Form is required for each student with a food allergy. (Physician signature required.)
  2. Medication Administration Form for each medication. (Parent and physician signature required.)
  3. Food Allergy & Anaphylaxis Emergency Care Plan (Parent and physician signature required.)
  • Students who require an antihistamine only need a letter from the physician stating the student does not require Epinephrine at school. The antihistamine should contain a prescription label and the required forms listed above.


EPINEPHRINE CHECKLIST: 

  1. Medication Administration Form (Parent and physician signature required.)
  2. EPINEPHRINE Checklist (Parent signature required.)
     

ASTHMA CHECKLIST: 

  1. Medication Administration Form for each medication. (Parent and physician signature required.)
  2. Asthma Form (Parent and physician signature required.)
     

DIABETES CHECKLIST:

  1. Medication Administration Form for each medication. (Parent and physician signature required.)
  2. Updated physician orders.
    ​​​​​​