Medication Authorization

Medication at School: If medication is needed at school, complete a Medication Authorization Form and have an adult bring it to school with the medication in the original container. Prescription meds and Over the Counter medications in dosages other than the recommended dosage for age and weight will also need a physician signature.

Medication Authorization Form

The form can be faxed to 920-459-2930, attention Kathleen Miller RN


scanned in and sent by email to

Please email the School District Nurse at or call 920-803-7287 if you have any questions.