Parental Agreement for School to Administer Medicine
The school will not give your child medication unless you complete and sign this form.

The medicine has to be prescribed by your doctor to be taken 4 times a day (once in school) with your child’s name clearly marked.
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Email *
Full Name of Child
 *
Child's Year Group & Class
 *
Child's Date of Birth
 *
MM
/
DD
/
YYYY
Medical Condition / Illness
 *
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