Consent For The Storage And Administration Of Medicines In School
Please complete this form if your child needs the school to administer medication to our child whilst they are in school.  Please note that we are only able to administer medication prescribed by your GP and that the medication should have the sticker affixed by the pharmacy on it giving details of your child and the dose required.  All requests will be reviewed by the Headteacher.
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Child's Full name and Class *
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Type of Medication *
For How Long Will Your Child Take This Medication *
Reason For Medication Being Given *
Name of GP *
Dosage, Method and Timing of Dose *
Special Precautions/Side Effects/Emergency Procedures *
Self Administration *
In submitting this form I understand that my child will be supervised whilst he/she takes their medication by a member of staff.  This arrangement will continue until the school are instructed otherwise.  I understand that it is my responsibility to deliver the medication to the school and accept that this is a service which the school is not obliged to undertake. *
Name of Person Making Request And Daytime Telephone Number *
Date of Request *
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E-Mail Address *
Any other information needed
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