Parental Agreement For School To Administer Medicine
This form is for children where an Individual Healthcare Plan or Education Healthcare Plan is not required.

The school will not give your child medicine unless you complete and sign this form, and the school has a policy that the staff can administer medicine.

If more than one medicine is to be given, a separate form should be completed for each one.
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Date form completed *
MM
/
DD
/
YYYY
Child's name *
Year group *
Medical condition or illness *
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