Dear Parents,

To protect your child's safety, the School Nurse and/or Health Aide will adhere to the following medication policy. Beginning August 1996 it was required that BOTH parent and physician's signature are on file before any prescription OR non-prescription medication is administered. This refers to ALL medications, including such products as Tylenol, Motrin, Dimetapp, etc.

Although this may cause some inconveniencel, we feel that this policy is best for the continued proection of your child and must be followed. If we do not have your written permission and the written permission of your physician, the medication will not be given. Permission forms are attached in the links above or may be obtained by contacting your School Nurse or Health Aide.

Please follow these instructions carefully:

• Obtain written request from Physician and Parent/Guardian. One separate form for each medication is required. Forms may be copied if you need more than one.
• The medication must be in the original container and have a fixed label that indicates the student's name, name of medication, dosage, method of administration, and time of administration.
• Medication must be immediately given to a staff member. No medication is to be carried throughout the school building.
• ALL controlled substances must be brought into the building by the parent/guardian and must be accompanied by signed permission forms.
• If your child is taken off medication or will no longer receive it at school, a written request to change or discontinue administration is required. Please make sure you sign and date your request.
• You may be asked to provide a photo of your child to attach to the permission form.
• You will need to provide new forms each school year as ALL forms expire at the end of each school year.

For your convenience, forms may be mailed or faxed. Please mark: Attention School Clinic. If you have any further questions or require any assistance, do not hesitate to call me. I can be reached at (330) 253-9113 ext. 133 (Monday-Friday from 9:30 AM - 2:30 PM).

Thank you for your cooperation,