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- This form is required for a student to take medication in school. This includes any prescription medication, over the counter medications, inhalers, epipens and insulin.
- It must by signed by BOTH parent/guardian and physician.
- Students who self carry inhalers, epipens or insulin must also complete this form.
- Students may only self carry insulin, epipens and inhalers. Any other medications (including over the counter) MUST be kept in the nurse's office.
- All medications must be supplied by the parent/guardian.
- Medications must be in the original container with prescription label. Over the counter medications must also be supplied to the nurse in it's original container.
- The Asthma Action Plan is required for all students with asthma along with the medication authorization form above.
- It is to be completed by a Parent/Guardian and Physician