Parental Agreement for School to Administer Medicine
This form is for parents to complete when a child requires medication in school. The school will not give your child medicine unless you complete and sign this form. The school request that parents only complete this from if their child requires to take/use medication for four or more times a day or agreed by Mr D Murphy depending on conditions/circumstances. If you have any questions about this form or relating to your child taking medication in school. Please contact the school on 0151 487 5678 or email

If child requires more than one medication a separate form must be completed for each medicine.

All information provided in this form is protected under the Data Protection Act and GDPR

This form is to be completed by person with parental responsibility

Note: Medicines must be in the original container as dispensed by the pharmacy and show the pharmacy label detailing name, dosage etc.

Thank you.
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