Consent for Administration of Medication or Physician Ordered Treatment During the School Day
Complete and return to nurse if your child requires prescription medication at school. Prescription medication will not be administered to the student without this form! (MD signature/parent signature required)
This form needs signatures from both the physician and guardian.
Consent for Administration of Non-Prescription Medication
Complete and return to nurse if your child requires non-prescription medication during the day, ie: Benadryl, Zyrtec, Tylenol, Advil, Motrin, over the counter eye drops, etc. (Parent signature required)
Self Administration Authorization of Homeopathic Remedies
Complete and return to nurse if your child will be taking Homeopathic remedies at school. (Parent signature/student signature, school nurse signature required)
Self Administration of Medication Authorization
Complete and return to nurse if your child plans to self-administer asthma inhaler at school. No other medication will be allowed to be carried by the student at CHA. (MD signature/Parent signature/school nurse signature required)