NOTE TO PARENT

Effective August 2021, medications without CURRENT orders will no longer be accepted. Please browse this page and download any forms you may need for next year.

Medication Forms

Prescription and nonprescription medication can be given at school with a written request from the parent/guardian and physician. If your child must have medication in order to remain in school, we request that the parent/guardian, and your child’s physician complete the Medication Permit form below and return to the office or school clinic. In order to expedite this process, you might want to take the form to your physician to be signed. Please return the completed signed form to the school nurse.

Please refer to the Parent Medication Letter for additional guidelines on medication at school.

For prescription and nonprescription:

Medication Authorization Form English / Spanish

Medication Short Term Administration 7-10 Days English /  Spanish

Only one-week supply of medication may be brought to the clinic in the properly labeled original container. Please request pharmacist to dispense two labeled bottles for medicine: one for home and one for school. We request that all medication be brought to school by the parent or an adult for reasons regarding safety. Therefore, please do not send medication of any kind to school with your student. Also, we cannot send any medication home with your child. It must be picked up by a parent or designated adult. Please contact your school nurse for further information if you have questions or concerns.

All medication should be given by the parent outside the school hours if at all possible. For example – three times a day medication should be given before school, after school, and at bedtime (every 8 hours) unless otherwise prescribed by your health care provider. Over the counter medications may be given at school if it cannot be given at home. Written permission from the healthcare provider and the parent/guardian is required.

For severe food allergies:

• Severe Allergy Action Plans - English / Spanish
• Food Allergy Parent Questionnaire
• Physician/Parent Authorization for Self-Administration of Emergency Medication
• Self-Administration of Anaphylaxis Medication -- Emergency Care Plan English / Spanish
• Special Diet Form  English / Spanish
• Physician/Parent Authorization for Self-Administration of Emergency Medication
• Self-Administration of Asthma Medication -- Emergency Care Plan English / Spanish

Adrenal Insufficiency

• Adrenal Crisis Action Plan

Seizure Action Plan

• Seizure Action Plan