Prescription Medication Form

Nonprescription Medication Form


  • Permission Form must be completed by the parent and the student’s physician.
  • Permission Form must be renewed annually.
  • Container must be labeled by the pharmacy with the medication name, dose, and doctor’s name.
  • Medication should be brought to the health office by the parent.


Nonprescription Medications

  • Original unopened container.
  • Sample size ok.
  • Plastic bag or mixed medication will be returned.
  • Will be given by manufacturer’s instructions unless otherwise authorized by physician.
  • No stock medications. Each student must have their own container.
  • Permission Form completed and signed by parent and renewed annually.
  • If medication is left at the end of the year, it is the responsibility of the parent to pick it up within 2 weeks of school ending. One letter or phone call with a reminder will be given.
  • All medications not pick up will be disposed of by the nursing staff.