Prescription medication consent form
Prescription Medication Consent Form

Please complete this form if your child has been prescribed medication by their GP or Hospital Doctor that needs to be taken throughout the school day.

Your child must bring the medication to the Student Welfare Office. The medication must be in the original box, with the pharmacy label on.  This will be locked away and kept safe for your child to take their medication in the Student Welfare room at the advised times and dosage required.  A record will be kept of each dose given to your child.

You will need to complete a form for each prescribed medication item.
Sign in to Google to save your progress. Learn more
Email *
Name of child *
Tutor Group *
Name of medication *
Dose and frequency of medication *
Expiry date *
MM
/
DD
/
YYYY
Parents signature of consent *
Any further information *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Harrow Way Community School. Report Abuse