Medical Authorization

Children receiving medication which is taken during school hours must have the medication brought to school by the parents or guardian. Do not send any form of medication to school with your child on the bus. This includes over the counter medicines such as cough medicine, cough drops, Tylenol, etc. Please fill out the attached form which states:

  • What the medication is for
  • How many times and how much should be given
  • Who prescribed the medication (doctor's name)
  • Possible side effects which may be anticipated and the length of time the child should receive the medicine
  • A parent or guardian and physician MUST sign the permission form.

This form, one for each child, must be completed by the parent, and signed by the physician before any medication will be given at school. Prescription medicines must be accompanied with the up-to-date prescription label, in the original packaging and with the doctor's directions. All medications will be kept locked in the school office.

Please complete the attached form and return it to your child's school office.

Thank you in advanced for your cooperation. If you have any questions please feel free to call your child's building secretary.

Medical Authorization Form