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Student Asthma and Allergy Action Plan Document

 Health and Administration of Medication Forms

Medications should be given at home whenever possible. Once a day medications
should be given at home, before school. If medication must be taken with food, milk or
toast can be given with it at home. If medication is twice a day, both doses should be
given at home, before and after school, unless specified differently on prescription.

• If your child must take medication at school, before any prescribed medications
can be given, an Administration of Medication Form must be filled out completely
by the prescribing physician and signed by both physician and parent/guardian. If there are 
any medication changes (dose/strength, time), a new Administration of Medication
Form must be filled out and signed by physician and parent/guardian.

• When more than one medication is to be given, an Administration of Medication Form
must be filled out and signed for each medication.

• If your child needs to take any over-the-counter medication, a note from the parent
stating the name of child, name of medication and the amount and time to be given and 
must be signed by parent/guardian.

All medications, whether prescription or over the counter, must be in the original
container with the name of the medication, directions and prescribed child’s name for the prescription.

Medication cannot be brought to school by a student unless authorized for self-
administration.

**ALL MEDICATIONS MUST BE PICKED UP BY THE LAST DAY OF EACH SCHOOL
YEAR BY PARENT/GUARDIAN OR MEDICATION WILL BE DISPOSED OF.

Administration of Medication Policy