• Request for Medication/Treatment During School Hours

    2021-2022
  • THIS APPLIES TO ANY MEDICAL PRESCRIPTION

  • Employment Resources Incorporated (ERI) requires that if medication/treatments are to be taken by a student during the school day, the school MUST have the following information completed and on file. In addition, this information MUST be updated as soon as changes occur:

    TO BE COMPLETED BY THE PHYSICIAN: (Please print)

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  • TO BE COMPLETED BY PARENT OR GUARDIAN:

  • I request that school personnel administer the above medication/treatment ordered by the physician as stated and according to the directions given. I authorize a representative of the school to share information regarding this medication/treatment with a health care provider in an emergency. I understand and agree to comply with the school’s policies and procedures.

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  • REQUEST FOR OVER-THE-COUNTER MEDICATION/TREATMENT Medical Standing Orders

    2021-2022
  • THIS APPLIES TO ANY OVER-THE-COUNTER MEDICATION

  • Employment Resources Incorporated (ERI) MUST have the following information completed and on file if medication/treatments are to be taken by a student during the school day. In addition, this information MUST be updated as soon as changes occur:

  • to receive the following over-the-counter medications administered according to the indications and instructions of that medication’s label.

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  • ASTHMA AWARENESS INFORMATION

    2021-2022
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  •    
  • Should be Empty:
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