Medication Forms

  • If your child requires medication at school, a parent or guardian has to bring that medication to the school nurse. 

    The following items are required:

    • Medication in the original container
    • A doctor’s order with instructions for giving the medication
    • Parent signature on the Medication Form (below)
    • If indicated: Attestation form (below) for self-carry (e.g. for inhaler)

    Please contact the school nurse with any questions.

  • Medication Form

    This form is to be completed by your child's health care provider for any medication (both precription and over-the -counter) that is necessary for your child to take at school. Please note that many healthcare providers utilize an Electronic Health Record that already has a "medication order for school administration" section; those forms are also accepted as a medication order, but must also be signed by parent to allow the school nurse to administer the medication. ALL MEDICATIONS MUST BE BROUGHT TO SCHOOL BY A PARENT/GUARDIAN IN THE ORIGINAL CONTAINER. 

    If a student must self-carry a medication at school (albuterol, epipen), the healthcare provider must sign an attestation form stating that the child is independent and able to carry the medication at school. ( see Attestation/Independent Medication Carry Form)
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  • Attestation for Independent/Self-Carry Form

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Last Modified on February 2, 2022