CARE PLANS:
Please print out and complete the care plan(s) that applies to your child’s medical condition.
Cardiac Care Plans must be completed and signed by your students Cardiologist. All other Care Plans may be completed by parent/guardian.  Please provide as much detailed information as possible to better help school staff to care for your child at school.
Return completed Care Plans to your student’s school clinic

MEDICATIONS AT SCHOOL:
All medications to be administered at school prescribed or over the counter require a completed Medication Authorization Form signed by your students Doctor.

The Doctor's orders must include:

• Name of the medication
• Exact dose (no dose ranges will be accepted ex 1 to 2 pills or 2 to 4 puffs)
• Daily medications must include the exact time of administration at school
• As needed medications must include the specific time frame to be given at school (ex every 4 hours as needed) Orders may not say "as needed” without a time frame
• If your student's medication needs to be crushed or capsules opened for administration this must be stated in the Doctor’s order

1. Required Forms

• A Contract to Carry must be submitted if a student will carry their own medication, including over-the-counter (OTC) medications.
• A Medication Authorization Form must be completed and signed by the prescribing physician.

2. Labeling Requirements

• Instructions on the pill bottle must match the doctor’s orders exactly.
  • If there are any discrepancies, the medication will not be accepted by clinic staff.

3. RN Approval

• All medication orders must be reviewed and approved by the School Registered Nurse (RN) before clinic staff can administer them.

4. Medication Delivery

• Students are not permitted to bring medication to school.
• An adult must deliver all medications to the clinic, including OTC medications, unless a Contract to Carry is already on file.

5. Annual Form Renewal

• All forms must be dated after July 1st for the upcoming school year.
• Forms must be renewed annually to remain valid.