Students Requiring Medication at School

Please complete the Medication Administration Authorization form for any medication to be administered to your student in the school setting.

A new Medication Authorization form must be completed for each medication and each time there is a change in dosage/instructions.

  • Non-prescription medication must be in the original container with the factory label and must not expire during the school year. 
    • Please complete sections 1 and 2 of the Medication Administration Authorization form. 
  • Prescription medication must be in the original container with a pharmacy label and must not expire during the school year. 
    • Prescription medications require BOTH the physician and parent authorization sections of the Medication Administration Authorization form to be completed (sections 1, 2, and 3).

ALL medication must be delivered to the office by a parent/guardian. Medication cannot be sent to school with a student. The school office staff will store and administer medications based on the authorization form. 

Self-Carry/Administration

No prescription medication is to be kept with the student UNLESS both physician/authorized prescriber and parent provide authorization for the following emergency medications only: Asthma Inhalers, Epi-Pen, or prescribed emergency medication. 

  • Prescription medication - All 4 sections of the Medication Authorization form must be completed for a student to self-carry a prescription medication.
  • Non-prescription medication - Sections 1, 2, and 4 of the Medication Authorization form must be completed for a student to self-carry/administer an over-the-counter, non-prescription medication.
    • 6th grade students and older are eligible to carry over-the-counter medications if authorized by parent/guardian.

Medication Administration Authorization Form