NY State Law requires prior written approval signed by a student's healthcare provider and a parent/guardian before school nurses can distribute prescription and/or over the counter medication (OTC) in school or on school trips. The nurses cannot administer any medication without this completed form. This form must be completed annually. Please upload completed forms to the August Schools electronic health record system requests section.

Additionally, an emergency action plan must be filled out by your child's medical provider for EpiPens, asthma inhalers, and/or seizure medications. Please contact your child's doctor for required forms for diabetes management.

Please list all other OTC and/or prescription medications the child will be taking during the school day and/or on school trips. You must provide the medication in the original pharmacy container.

An emergency care plan must be filled out by your child's medical provider for Epi-Pens, inhalers, diabetes or seizure medications. Please contact the nurses or your child's endocrinologist for required forms if your child has diabetes.

I hereby give my permission for the school nurse to administer the over the counter medications and the prescription medications listed above during the school day and/or on school trips.