All students must fill out a Health History Form to attend the senior trip whether they take medication or not. All students need to fill out the entire form(s). There are two different types of medication that need to be included on the forms:
Over-the Counter Medication (View Form Here)
Over-The-Counter medication brought on the trip must be in the original unopened packaging and labeled with the student's full name.
Examples: Benadryl, Flonase, Ibuprofen, Acetaminophen, Naproxen, Aspirin, Antacids, Dramamine
*Exact medication names must be included.
Prescription Medication (View Form Here)
All prescriptions require a note from the student’s doctor.
If any new prescriptions are added after this form is turned in, a new form must be submitted with a signature from the doctor.
All prescription medications require a signature from the prescribing doctor.
Prescription medication must be in the original prescription bottle and must be prescribed for that student with their name on it.
Any Prescriptions must be current and the date filled must be within 30 days of the trip.
Distribution of Medication
Parents must fill out a form to identify if they would like students to be responsible for their own medication, or if they would like chaperones to dispense medication. At least one of these forms must be filled out if your student is bringing any medication on the trip.
Student Form - Student Dispensed (Self-Medicating) Medication Form
Parent Form - Student Dispensed (Self-Medicating) Medication Form
Physician/Doctor Form - Student Dispensed (Self-Medicating) Medication Form (Prescription Medications)
*If a student will be keeping their medication on them and administering it to themselves then they need these forms. It is a 3-part form, one page is for the parent, one for the student, and one for the physician. (The physician only signs if the medication is a prescription.)
**For legality purposes, students cannot keep controlled medications such as Adderall and certain ADHD medications on them. These must be kept by a school staff member and remain locked at all times.
The nurse will not be sending any medication on the trip, so anything your student needs to bring must be included on this form. Please think about common medications that your student takes for pain, allergies, motion sickness, or other conditions. Your student cannot bring any medication on this trip that is not included on their form, so please be thorough.
Please get in touch with Nurse Beehner (jennifer.beehner@spart1.org or 864-457-2606 ext. 4509) if you have any questions or need clarification.