Student Medication Request and Agreement
Where possible, student medication should be self-administered by the student/care-givers at home, other than during school hours.
The doctor prescribing the drug must be aware that the school will supervise or carry out administration of the medication on the instructions provided. It is therefore necessary that the doctor provide additional instructions to staff regarding special requirements as per the 'Medical Instructions from Prescribing Doctor' form. These instructions are a mandatory requirement and are necessary when school staff are to administer the drug, supervise the administration of the drug, or monitor the student after drug administration. Drugs for administration should be delivered to the school into school care. The school will prepare a student medication record and store the drugs in a secure place. All drugs should be contained in properly labelled containers showing the name of the student and the appropriate dose and frequency.
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Date of Birth
Name of Prescribing Doctor
Medical condition being treated
Dose/Time to be taken
It is the responsibility of the parent/guardian to provide the correct drug properly labelled. Improperly labelled drugs WILL NOT be adminstered.
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