Parental agreement for school to administer medicine

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Parental agreement for school to administer medicine

The school cannot give your child medicine unless you complete and sign this form

Email *

Child's name: *

Please select your child's class:
*

Medical Condition/illness

e.g ear infection, hayfever

Medicine: Medicines must be the original container as dispensed by the pharmacy. The school is only able to administer medication that has been prescribed.

Name/Type of Medicine (as described on the container): *

Date dispensed: *

YYYY

Expiry date: *

YYYY

Dosage and method:
*

Time to be taken *

Time

Any special precautions/side effects to be aware of? *

My child is able to take their medicine themself *

Yes

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