St. Athanasius School Medication Permission Form
Many times it is necessary to take medication during the school day.  To assist the school in monitoring all medications that are brought to school and administered, a medication permission form is required for any student with medication.  This is required whether the medication is for a prescription drug or an over-the-counter drug. All medications are to be kept in the office.  An exception is made for inhalers and cough drops which may be kept in the teacher’s desk if so stated on the written permission form.

Prescription medications should be sent in the labeled container received from the primary physician.  This serves as the physician’s authorization.  

Please send over-the-counter medications in their original containers.  Medication that is sent to school and is unlabeled (or labeled by the parent, but not in the original container) and without written permission will not be administered to that student and will be returned to the parent.  The school is not required to attempt parental contact prior to administering an OTC medication if the parent has indicated permission on this form.

Below is the medication permission form which must be completed and returned to school for your child to have medications administered during school hours.

This form may be printed out and returned to the office as circumstances dictate throughout the school year.
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Email *
Name of Student *
Prescription Medication Name and Dosage (as needed) -
Over-the-Counter Medication - I give permission for the school to administer only the OTC medications checked below at the package's recommended dosage.  
Allergies *
Acceptance *
Date *
MM
/
DD
/
YYYY
Submit
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