Parental Agreement for Avon Valley School to Administer Medicine
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Email *
Student's Name *
Date of Birth *
MM
/
DD
/
YYYY
Tutor Group *
Condition / Illness *
Name of Medicine *
Date Dispensed (from Pharmacy)
Expiry date
MM
/
DD
/
YYYY
Date bought (from Chemist / shop)
Expiry Date
MM
/
DD
/
YYYY
Dosage, method and timings *
Special  precautions *
Side effects that the school need to be aware of *
Self Administration *
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