Permission

Forms

Use these forms to provide permission for medications to be administered at school.

Med Permission Form_2020-2021.pdf
Spanish_Med Permission Form_2020-2021.pdf


Helpful Hints:

  • Medication should be administered at home by a parent or guardian before or after school hours, when possible.

  • Initial doses of medication (that a child has not taken before) will not be administered at school.

  • Prescription medication to be administered at school ( if unable to do at home ) should be accompanied by this form completed by parent and prescribing physician ( health care provider )

  • Non prescription medication can be administered with the above form completed by the parent only, as long as the dose is not stronger than the label recommends per age/weight. If you want a dose given that is stronger than the directions on the label then the form must also be signed by the physician.

  • All medications must be in the original labeled container whether non prescription ( ex Tylenol/Advil ) or prescription. We will not administer any medication that is not in the original container. The prescription label must match the physician orders, name, medication, dose and time.

  • Only one medication per form please: ex Tylenol ( one form ), Emergency epinephrine ( another form ).

  • Each new school year requires all new Medication Permission Forms to be completed.