Medication Administration Form

  • A provider medication order is required for all medication (over the counter and prescription) that is administered in school. The Medication Administration Form (shown below) must be completed and on file in the nurse's office.

    Medications that can be taken at home before/after school should be arranged in this manner. 

    All medication must be supplied by the parent/guardian. Over the counter and prescription medication must be in original over the counter packaging or original pharmacy labeled container.

    The provider medication order on the Medication Administration Form expires at the end of each school year.  A new Medication Administration Form must be submitted every school year.

    Medication must be retrieved from the nurse's office at the end of the school year, or it will be discarded.

Medication Administration Form

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