LCS School Nurse

MEDICATION FORMS

Administration of Medication

ALL medication forms must be completed yearly and given to the school nurse by the first day of school

along with current, unexpired medication.

Bernards Township Board of Education Policy 5330 requires that any medication including over-the-counter medications (this includes all medication, even cough drops!) requires a completed "Request to Administer Medication" Form that contains the following information:

Parental Permission
Physician's Order-Diagnosis, Medication, Dosage, Route, Time, Side Effects, Length of treatment, Activity restrictions.
Medication must be delivered in the original labeled bottle to the school nurse by parent/guardian. Students may not bring or take home medications to school.

Epinephrine Auto Injector MD Order Form

Asthma Action Plan - MD order form

General Medication Order Form

PLEASE NOTE - ALL medication , prescription AND over the counter medication needs an MD order when given at school

General Medication Order - Spanish

Seizure MD Order Packet

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