Get the free Request for Administration of Medication at School

This document serves as a request for school staff to administer medication to a student, requiring completion by parents and a prescribing physician.

How to fill out request for administration of

How to fill out Request for Administration of Medication at School

1. Obtain the Request for Administration of Medication form from your school’s office or website.
2. Fill in the student's full name, grade, and date of birth at the top of the form.
3. Provide the name of the medication, dosage, and frequency it needs to be administered.
4. Include specific instructions for administration, such as whether it should be taken with food or at specific times.
5. Provide the physician’s information, including the name, contact number, and signature if required.
6. Have a parent or guardian sign the form to give consent for the medication to be administered at school.
7. Submit the completed form to the school nurse or designated staff member.
8. Keep a copy of the form for your records.

Who needs Request for Administration of Medication at School?

1. Students with chronic health conditions requiring regular medication during school hours.
2. Students who need temporary medication, such as antibiotics, that must be administered while at school.
3. Students with allergies requiring emergency medication, such as an EpiPen.

For pdfFiller’s FAQs

What is Request for Administration of Medication at School?

The Request for Administration of Medication at School is a formal document that parents or guardians must complete to allow school personnel to administer prescribed medication to a student during school hours.

Who is required to file Request for Administration of Medication at School?

The parent or guardian of the student requiring medication during school hours is required to file the Request for Administration of Medication at School.

How to fill out Request for Administration of Medication at School?

To fill out the Request for Administration of Medication at School, the parent or guardian should provide the student's information, details of the medication, dosage, administration schedule, and any special instructions, and sign the form.

What is the purpose of Request for Administration of Medication at School?

The purpose of the Request for Administration of Medication at School is to ensure that students who need medication during school hours can receive it safely and in accordance with medical instructions while adhering to school policies.

What information must be reported on Request for Administration of Medication at School?

The information that must be reported includes the student’s name, date of birth, name of the medication, dosage, route of administration, frequency, reason for medication, and any known allergies or side effects.