• KATY ADVENTIST CHRISTIAN SCHOOL

  • Permission to Administer Medication

  • Parents: Complete this form and return to the Office with the medication to be given.

    I hereby request and grant permission to the Katy Adventist Christian School. to administer medication to my child. If the school administrator / nurse deems it necessary, I also grant the school administrator / nurse permission to notify my child’s teacher(s), either verbally or in writing, of this medication and of possible reactions that might occur. I further state that this medication cannot be scheduled for other than school hours. I understand that oral medication, inhalers, nebulizers and oxygen administration may be given by a medically untrained designate of the principal as per Texas Education Code, Section 22.052.

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  • PLEASE NOTE THE FOLLOWING MEDICATION POLICIES

  • 1.All medication must be in its original container and be properly labeled. The pharmacy label must state the student’s name, medication, dosage, doctor’s name, and date prescription was filled. The prescription is to be current within the last 12 calendar months. Non-prescription drugs should have the student’s name affixed to the original bottle, and the doctor’s orders. 2.After five (5) consecutive school days, students on non-prescription drugs will be required to submit a physician’s authorization for continuance of medication. 3.Any unused medication left over two weeks after the last dosage will be destroyed. 4. Changes in prescription medications require either a new prescription labeled bottle or written physician request for dosage change. A new parental permission request is to accompany any change in medication. 5.It is requested that medication be brought to the office by the parent and given to the school designated person. No medication will be transported by any school transportation service personnel. 6.Vitamins, minerals, diet supplements, and special diets will not be administered by school staff except from a physician’s written order.

  • Katy Adventist Christian School

  • CONSENT TO TREATMENT

  • Only designated staff will have access to the completed form. This form will be stored in a locked file.

    This form must be filled out at the beginning of each school year to cover the activities for the school year. A copy of each student’s form must be taken on off-campus activities.

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  • Please give the names of two relatives or friends who have consented to assume the responsibility of your son or daughter in case of illness or accident until you can be reached. In case of any changes in the named persons, notify the school in writing.

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