Permission to administer prescribed medication in school (including asthma)
The school will not give your child medication or supervise them taking it themselves unless you complete this form. The school or education setting has a policy for staff to administer medication.

We expect you to notify us first thing in the morning if your child has all ready had any medication before attending school.

School staff, who have received appropriate training, will be covered by indemnity as set out in KCC guidance (section 10 paragraph 2:1 & 5:2 Supporting pupils with medical needs).

We will take this permission for the duration of the specific medication and will not be used once they have finished.
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Child's Name *
Child's class *
Name of medication to be administered *
If this is asthma medication please select ONE of the following statements
Clear selection
PLEASE NOTE If you tick either of the boxes for asthma medication, you will be required to provide either one or two pumps with valid expiry dates.
Duration of course
Dosage *
Time of day to be given
Date prescribed *
MM
/
DD
/
YYYY
Any known side effects
DECLARATION: I understand that I must deliver medicine personally to the School Reception and accept that this is a service that the school is not obliged to undertake. I confirm that my child’s doctor has stated that he/she considers it is necessary for the medication to be taken during school hours. Please print your full name here. *
Submit
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