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Medical Forms and Policies

Student Medication Forms


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 office, please remember:
* In order for the required forms to be accepted, all sections (including the photo) must be completed. Medication and all completed forms must be submitted together to be accepted.
* Before submitting the medication to the nurse's office, parents must update the name and dosage of medication to be administered on the student's health and emergency form in FACTS.
* If you wish for medication to be available to your student during After Care, please bring the additional medication during the initial medication drop-off.

FOOD ALLERGIES: 
(Students who require Benadryl only need a letter from the physician stating the student does not require an Epi Pen at school.)


EPI PEN: 

ASTHMA: 

DIABETES: