Forms

MEDICATION PERMISSION FORMS

***Prescription AND non- presciption medication forms including daily medication, epi-pens, inhalers and nebulizing meds must be signed by both the Physician and parent before medication can be accepted by the Nurse.***

Daily Medication, Prescription, and Non- prescription:  

**Please read Medication Procedures section of the permission form prior to completing **

**Any change in dosage of non-prescription medication other than recommended on the package label, must have M.D. signature**

*** New 24/25 school year policy- ALL over the counter medications need both parent and Doctor signature***

New Request to Admin Form

Inhalers:

Students who will keep inhaler in Nurse's clinic:

**This form must be completed by MD and signed by parent** (Dr. omits permission for student to self carry inhaler)

Click here to access the required form : Asthma Action Plan

Students who will self-carry inhaler: 

**This form must be completed by M.D. and signed by parent** (Dr. gives medical permission for student to self carry by checking the box towards the bottom of the page that states student may self-carry)

This is very helpful for those students participating in athletics.

Click here to access the required form : Asthma Action Plan

Epi-pens:

**This form must be completed by M.D. and signed by parent**

Click here to access the required form : Food Allergy and Anaphylaxis Emergency Care Plan ( FARE)