Medication Forms

  • Elementary School Families: If your child needs medication at school and will be attending in-person learning, you will need to schedule an appointment with your school nurse to drop off your child’s medication. When dropping off your child’s medication, 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)

    You must wear a mask to enter the school. At the entry door, you will have your temperature taken and must answer screening questions before meeting with the nurse. Please reschedule your drop-off if you have any signs of illness, and 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 September 22, 2020