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This document is an authorization form that allows students to self-carry and self-administer prescribed medications, specifically for asthma and allergy emergencies. It must be completed by a prescribing health professional, and requires signatures from the parent/guardian and student. The authorization is valid for one school year and needs to be renewed annually.
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How to fill out medication self-carry authorization

How to fill out medication self-carry authorization
01
Obtain the medication self-carry authorization form from your school or healthcare provider.
02
Fill out the student's information, including name, date of birth, and grade.
03
Provide details of the medication, including the name, dosage, and frequency of administration.
04
Include any specific instructions regarding the self-carry of the medication.
05
Obtain signatures from both a parent/guardian and the prescribing healthcare provider.
06
Submit the completed form to the school administration or designated official.
Who needs medication self-carry authorization?
01
Students with chronic medical conditions who require daily medications at school.
02
Students with severe allergies who may need emergency medication, such as an epinephrine auto-injector.
03
Students with asthma who need to carry their inhalers.
04
Any student who needs to carry medication for a specific condition while on school premises.
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What is medication self-carry authorization?
Medication self-carry authorization is a formal permission that allows a student or individual to carry and administer their own medication while at school or during school-related activities.
Who is required to file medication self-carry authorization?
Typically, students who need to carry and self-administer their medications, such as those with chronic health conditions or allergies, are required to file medication self-carry authorization.
How to fill out medication self-carry authorization?
To fill out medication self-carry authorization, individuals usually need to complete a specific form provided by the school, which includes details about the medication, the dosage, the prescribing physician, and signatures from both the parent or guardian and the healthcare provider.
What is the purpose of medication self-carry authorization?
The purpose of medication self-carry authorization is to ensure that students can safely manage their medical needs while promoting their independence and ensuring that schools comply with health regulations.
What information must be reported on medication self-carry authorization?
The information that must be reported on medication self-carry authorization typically includes the student's name, details of the medication, dosage instructions, the prescribing physician's contact information, parental consent, and any additional health information pertinent to the student's condition.
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