Glass

Medical Authorization Forms

This page is still under construction. Please request the paper forms from the front office.

Authorization for Administration of Medicine or Special Procedure

Parents should complete this form when their student has medications that need to be administered during the school day. Special health care procedures and medications may be prescribed for administration by school personnel as follows:

  1. When such treatment cannot otherwise be accomplished

  2. On receipt of this completed form along with prescription and or special equipment items

  3. Please request pharmacist to dispense two labeled bottles of medication: one for home and one for school

Authorization for Life Threatening Allergy Emergency Plan

Parents should submit this form when their student has a life threatening allergy or condition that requires an emergency plan.