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School Medication Prescriber/Parent Authorization Form

HEALTH & NUTRITION MANAGER PAGE

nurse image

Office Phone: 256-775-0234 Ext. 7001

Email Mrs. Whittle

For any medications to be administered at school, you need to submit the following items:

  • A Medication Authorization form completed and signed. (You may print the forms using the links below each form below.)
  • The medication must be in an original, unopened, sealed container identifying the medication and the manufacturer’s labeling plus the student’s name written legibly on the container (supplied by the parent/guardian).
  • The medication must be carried to and signed in at school in the nurse room by the parent/guardian.

 

Medication Authorization Form

The form below should be printed, completed and returned to the school nurse before medication can be administered.  Click the form to access the printable version. 

Medication Authorization Form