Please select any medical conditions that your student has. If your student has no known medical conditions, you may skip this step.

Listed below are the Over the Counter (OTC) Medications that the nurse has available in the School Health Office for students on an as needed basis. We hope that using these medications, as needed, will reduce absenteeism, and allow students to continue to participate in class in certain situations. If a student needs routine medication, or begins requesting these medications on a regular basis, parents will be asked to make arrangements to provide medication for their student's needs. Please note- NO CHEWABLE forms are available- parents must provide these if needed.

All OTC medications will be administered based on package age/weight dosing guidelines.

If you do not wish to authorize OTC medications for your student, you may skip this step.

If your student has a medical condition listed above, the School Nurse may contact you to review their condition and develop an Emergency Action Plan for your student. If there are any other health related concerns that you would like the school to be aware of, please contact the School Nurse by emailing: weldjod@wc.k12.wi.us, or calling 608-464-3165 ext 131.

By typing my name below and submitting this form, I acknowledge that this will be used as my signature for this form and I hereby give permission and authorize the Wonewoc-Center School District Staff to administer the above selected OTC Medication(s) based on package/weight dosing guidelines and release the district and employees from any liability claims as a result of the administration of the above selected medications.