Medical Alert Form/Request for Administration of Medication at School

PLEASE NOTE : You will only have to fill out the Medical Alert Form if medication is kept at the office for you child.

An updated Medical Alert Form must be provided at the start of each school year with new medication so that it will not expire for the entire school year.

Section A is to be completed by your physician/licensed medical practitioner if they have recommended medication to be taken at school either on a regular basis or on an emergency basis.  NOTE :  If having the physician/licensed medical practitioner complete this form becomes an obstacle, please contact the District Administrator for Student Services.

The First Page and Section B is to be completed by the parent/guardian.

Any changes in medication or dosage will require an updated form.  It is the parent’s responsibility to ensure that any changes in medication are brought to the attention of the school principal.