Private Physician Request for Administration of Medication During School Hours

This form must be completed by a Parent/Guardian and signed by a Physician to allow the Health Office to administer medication to a student during school hours. Some information requested on this form includes the name of the medication, dosage, administration schedule, possible side effects, and additional medication taken by the student.

request_for_admin_of_med_during_school.pdf, 6.73 KB; (Last Modified on June 8, 2020)