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Medication Administration

Medication Authorization Forms

Medication Authorization forms must be filled out for each medication that a child is to receive during a school day. If a child has a condition such as asthma or receives an emergency medication, a primary care authorization form must also be completed. Only emergency medication may be carried by a student if authorized to do so on their Primary Care Authorization Form. Daily medications including over the counter as needed medication must be kept a locked supervised area and only be administered by trained staff.

• Authorization to Give Over the Counter Medications
• Authorization to Give Prescription Medications
• Medication Administration Record
• Medication Disposition Form
• Medication Administration Incident Report Form

Primary Care Provider (PCP) Authorization Forms

Primary Care Provider (PCP) Authorization Forms are required for each known health condition. They are to be completed and signed by the healthcare provider and the parent. They are not valid until signed by both parties. The forms are kept at the school and provide an individual emergency plan for the student. The forms are also to be faxed to Health Services at 485-3670. If you have any questions, please call Health Services at 485-3387.

• Asthma /Allergy
• Diabetes
• Gastrostomy Tube/Swallowing/Feeding Disorders
• Tracheostomy/Suctioning/Replacement/Supplemental O2/Pulse Oximeter
• Other (including oral/nasal suctioning and catheterization)
• Seizure
• Health Service Log Form

Field Trip Information

The Field Trip Video training will no longer be available. If a child requires medication while on a field trip, staff must complete the Health Services Medication Administration Training for Unlicensed School Personnel. If medications, epipens, inhalers, diastat or glucagon are to be taken on the field trip, a trained staff member must accompany the child on the field trip. Remember that the training is only valid for one school year. Please check PD Central for a list of training dates.

Date Modified 6/22/11