I understand I will be notified if my child exceeds the seven dose limit and asked to sign and return the Non-Prescription Medication Consent and Order form to the school nurse. The school nurse will then forward the form to my child’s physician to obtain a medication order for the medications listed above.
1. By providing my digital signature below I agree that the above information has been completed to the best of my ability. 2. By providing my digital signature below I agree that although my child’s health information is confidential, it may be shared on a need to know basis with school staff including substitute nurses and my child's teacher. A copy of this information may be given to a school staff member accompanying my child on a field trip or school outing. A copy of this information may be given to EMS in the event of an emergency.
3. By providing my digital signature below I acknowledge that I have read and understand both the medication and physical exam policy of Sturgis Charter Public School, which can be found on the school website to the right side of the page by clicking health offices under the department header at the top of the page.
4. By providing my digital signature below I understand that in case of illness or injury to my child, the school will make every effort to notify me. If I can not be reached, the school will notify the emergency contacts listed above. In the event that emergency medical care is necessary and I cannot be reached, I grant full power to Sturgis Charter Public School to contact emergency medical services and/or arrange transportation to the nearest medical facility for treatment and sign releases as required by the medical facility to obtain any medical or surgical treatment in the judgment of medical authorities at the facility.