Permission to Give Medication Forms:Physician Request to Administer Medication During School Hours (Required for medication to be given at school for more than ten calendar days.)Parent Request to Administer Medication (Required for medications to be given at school for less than ten calendar days at school.)Medication Policy
Whenever possible, medications should be given before and after school hours. However, if the student needs to take medication during school hours, the rules listed below shall be followed. Please note the different requirements for prescription medication, non-prescription medication, and medicine prescribed for pain.
1. All medication must appear to be in the original container, properly labeled (name of student, name of medicine, and dosage), and must be kept in the clinic to be administered by a designated person.
2. A written request to administer medication is required from the parent, legal guardian, or other person having legal control of the student. This written request must include:
a) The complete name of the child.
b) The name of the medication.
c) The reason for administering the medication.
d) The amount of medication to be administered: (must not exceed recommended dose)
e) The time the medication is to be administered.
f) Any known drug allergies.
3. Properly labeled medicine provided by a physician or dentist requires a written physician's statement if the student must take the medicine during school hours.
4. A student with asthma or severe allergic reaction (anaphylaxis) may possess and self-administer prescription asthma or anaphylaxis medication with a written statement from parent/guardian and physician. The physician's statement must include:
a) The student is capable of self-administering the prescription asthma or anaphylaxis medication;
b) Name and purpose of the medicine;
c) The dosage of the medicine;
d) Time the medicine is needed or circumstances under which the medicine may be administered; and
e) The period of time for which the medicine is prescribed.
The school nurse MUST be made aware of any student that is self-carrying and/or self-administering medications and/or treatments. ALL medication(s) MUST be properly labeled at ALL times while on campus.
5. A student with diabetes may possess and self- administer prescription insulin and test for capillary blood sugar levels with a written Diabetes Management and Treatment Plan (DMTP) developed and approved by the physician and parent. The DMTP must include the following statements/information:
a) The student is capable of self-testing and self-administering the insulin.
b) The dosage of insulin to be administered.
c) The circumstances which testing or medication administration is to take place.
d) The period of time the request is valid.
6. If medication is to be administered longer than ten calendar days or as needed throughout the school year, the school must receive written permission from both the parent and physician.
7. Pain medicine (any narcotic) will not be administered during school hours. Narcotic pain medications usually cause dizziness, sedation, and unsteadiness, which is unsafe for the student in the school environment. Exceptions to this policy can be made for a student with chronic/long term pain problems if specified in writing by the student’s physician.
8. Non-prescriptive medication will be given only when prior arrangements have been made with the school nurse or designated person administering medications.
9. Herbal and dietary supplements will not be given during school hours.
10. An adult must transport all medication of students in Pre-Kindergarten through fifth grades. No students will be allowed to transport any controlled medication (medication for ADHD, anti-anxiety medications, pain medications or narcotics).11. A student in grades sixth – twelfth grades, may transport his or her medicine if parents/legal guardians accept the responsibility of the student’s capability of handling the medicine. All medication must be taken to the clinic upon the arrival of the student at school.
12. All medication in the school clinic must be picked up by an adult on the last day of school for students in grades Pre K through fifth. Medications left in the clinic after the last day of school will be discarded unless other arrangements have been made with the school nurse.