If your child needs a prescription medication to be given during the school day, please submit appropriate forms as soon as possible, so we may begin to give the prescription medication as soon as possible and/or be prepared for any emergency which might arise.
These permissions must be completed at the beginning of each academic year and renewed as needed:
Medication Order
For prescription (and prescribed over the counter) medications this form must be filled out and signed by both the prescribing physician and the parent/guardian and returned to the school nurse.
Medication must be delivered to the school nurse in a pharmacy labeled container by the student’s parent or guardian. The first initial dose of a medication cannot be given while on a field trip.
Self-Administered Medication Order
Use this form for certain prescription medications that may need to be self administered during school. These may only be medications for the following:
- Students with asthma or other respiratory diseases may posses and self administer prescription inhalers.
- Students with medical conditions requiring enzyme supplements may possess and administer them.
- Students with diabetes may possess and administer glucose monitoring tests and insulin delivery systems.
- Students with life threatening allergies may possess and administer prescription Epinephrine. (Must also include Allergy Action Plan form)
Self-Administered Medication Order
Medication Administration on Field Trips
In order to comply with state and local regulations, medication administration by school personnel must be approved and delegated by the school nurse. The required documentation must be submitted no later than one week before the scheduled field trip. Designated school personnel will be trained in the administration, contraindications and side effects of each medication.
Medication Administration on Field Trips
Allergy Action Plan
This form is required for students who must carry an Epi-Pen for anaphylaxis, a severe allergic reaction. This form must b e completed and signed by the prescribing physician as well as the parent/guardian.