Medications in School-Forms
Current district policy is that all medications must be brought to and picked up from the health office by a parent or guardian. DO NOT send in medications with children.
When it is absolutely medically necessary that a medication be administered during school hour (whether daily or for emergencies), a written medical order from a physician is required and the following steps must occur:
The order must specifically state: your child's name, medication name, dosage and form it comes as (such as 'one tablet (or tsp) every 4 hours), time to be given (ex. noon) and any pertinent instructions.
Please use the proper form for the specific medication-see forms below and download the needed form to take to your doctor
Parental consent/authorization MUST be signed
All medications must be given to the health office in the original container with the pharmacy label.
The medication order/dosage and the medication provided must match exactly.
Over-the-counter medications (including cough drops and Benadryl) follow the same procedure (although a pharmacy label is not required in this case).
Please check expiration dates on all medications submitted. If possible, please send in medications that will last through the school year. Medications that have previously expired will not be accepted.
Medication Forms
1. Epinephrine Packet - (Epinephrine with/without Benadryl)-Download and complete all pages
Epinephrine Indemnification Form-this form must be completed
Epinephrine Delegate Permission- Delegate form-A delegate means that, in an emergency and the nurse is not present, Benadryl may be omitted and epinephrine only given. Your child's doctor will decide whether a delegate will be allowed.
Epinephrine Medication Order- The doctor MUST specify how often (ex. every 4 hours) the antihistamine is to be given. Please print the doctor's name near their signature. You must sign the authorization line under the doctor's signature and write your phone/cell #.
2. Asthma medication form - please be sure to sign the bottom of the first page or it will not be accepted. Both sides of the form must be completed
Asthma Treatment Plan NJ-may be printed in black/white
3. Basic Medication Form - both sides MUST be completed