Dear Parents,
In order to protect the health and welfare of children, Indiana rules and regulations require that schools observe certain
safeguards in the administration of medication to students during school hours. In order to comply with state laws, the following
procedures will be observed.
1) Prescription medications must be brought to school and kept in the pharmacys original container.
Prescription infers physicians order and approval. This includes over-the-counter drugs as well as
prescription medications. Only this form (Consent for Administration of Medication) will be accepted for administration of
medication at school.
2) Medication, whether over-the counter or prescribed, must be brought to school and kept in the original container and placed in the
building principals office or the nurses office in a secure manner. Any medication sent to school may no longer be transported
home with the student. Please refer to Health Form 1B for more information.
3) Consent to administer this medication during school hours is valid for the current school year. If at all possible, medication
should be scheduled to be given at home other than school hours. Should your child require this medication on a long-term
or continuing basis, we must again ask your permission each year.
4) Medication will be administered by the building administrator and/or his/her designee in the absence of the administrator.
5) Adult strength over the counter medication will not be given to students under 12 years old unless accompanied by a doctors
order.
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TO BE COMPLETED BY PARENT/GUARDIAN
