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Senior Trip Medical Form
Senior Trip Medical Form
The Class of 2027 Senior Trip will be from Tuesday, March , through Saturday, March
Completed Medical Forms are due to the school Nurse, Mrs. Luckiewicz NO LATER than September 18, 2026.
A physician must sign this if a student takes prescription medication.
If the student does not take prescription medication but only over-the-counter medication, a parent/guardian may sign the form. If prescriptions change at any time before departure, please complete a new form and send it to Mrs. Luckiewicz ASAP.
Please list any/all over-the-counter medications a student takes. This includes vitamins.
Protein Powders and supplements ARE NOT permitted.
Medical Forms are due before September 18, 2026.
Forms can (and should) be updated as student's prescriptions needs change over the course of the school year.
Sr. Trip Medical Form 2027.docxSenior Trip 2027 Student Medical Form
Senior Trip 2027 Student Medical Form
Please download and complete this form.
List any/all over the counter medications; such as but not limited to pain/fever relief, allergy medicine, acid reducers, etc.
If your student only takes over the counter medicines, only a parent/guardian signature is needed.
List any/all perscription medication; a Physician's signature is required in addtion to a parent/guardian signature.
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