Medical Forms
Medical Forms
Medication Policy
Medication includes: prescription, non-prescription, over-the-counter, and herbal medications, and includes those taken by mouth, by inhaler, injection, and those applied as drops to eyes, nose, as well as all medications applied to the skin. Click on this link below to download a “Medical Permission Form for Prescribed Medication”. It must be completed and returned to the school prior to any medication being administered to the student.
This form must be renewed each year. Written instructions from a physician must include the name of the student, the name of the medication, dosage of the medication, route of administration, and time the medication is to be administered to the student and shall be kept on record by the school.
Any adverse reaction to medication, as described on the physician’s written instructions, shall be reported to the student’s parent/guardian immediately. All medication shall be kept in a labeled container as prepared by the pharmacy, physician or pharmaceutical company with the student’s name, the name of the medication, dosage, and the frequency of administration.
Medications must be brought to the school by the student’s parent or guardian. No changes to medication dosage or time of administration will be made except by written instruction from a physician.
Please fill out the following forms as needed
The School Based Asthma Management Plan form below must be completed and returned to the school prior to any medication being administered to the student.
The School-Based Care Plan for the Student with Diabetes form below must be completed and returned to the school prior to any medication being administered to the student.