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Rankin District #98Over the Counter Medication Authorization FormStudents Name:Birth Date:20222023Grade:Illinois State Law requires a written medical authorization by a Health Care Provider (physician,
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The school medication authorization form is a document that allows a student to receive prescribed medications during school hours, ensuring that the school has the necessary permission and information from a parent or guardian.
Parents or guardians of students who require medication during school hours must file the school medication authorization form.
To fill out the school medication authorization form, parents or guardians should provide the student’s information, details of the medication, dosage, administration times, and parent or guardian signature along with the healthcare provider's signature if required.
The purpose of the school medication authorization form is to ensure that students can receive necessary medications safely and in accordance with state regulations, while keeping school staff informed about the student's health needs.
The form must report the student's name, date of birth, medication name, dosage, administration route, frequency, duration, and any special instructions, along with signatures from both a parent/guardian and a healthcare provider.
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