Featherby New Medication Form
Please fill in this form to let us know of any NEW prescribed medications your child is required to take whilst in school.

If your child has an asthma pump this must be sent in via your child's class teacher on the first morning. ANY OTHER medications must be brought to the school office on the first morning.

** Please note - If we already know about your child's medication you do not need to fill in this form.  This is for new medications (since the last time they were in school) and medication that has been prescribed ONLY.  **

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Email *
By collecting the email you are using, this enables us to verify you have parental responsibility for the child.
If we have any concerns about the complete of the form, we will contact you before any medication is given.
Child's Full Name *
Child's Date of Birth *
MM
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DD
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Which class is your child in? *
What medication(s) is your child required to take in school? *
What is the medication(s) for? *
How often must it be administered? Please state dosage & time(s) *
How long is your child required to take this medication for? e.g. 1 week / until finished etc. *
Is there anything else we should be aware of? e.g. must be taken before/after food etc? *
Full Name of parent/carer consenting to this medication being administered *
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