Forms

MEDICATION PERMISSION FORMS

**Please read Medication Procedures prior to completing any permission form.**

***Prescription 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.***

Non- prescription, Prescription, and Daily Medication:

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

Click here to access the required form : Request to Administer Medication

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 in Middle School may carry their inhalers. This is very helpful for those students participating in athletics.

**This form must be completed by M.D. and signed by parent** (Dr. gives medical permission for student to self carry)

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)