Carman Trails Medication Pick Up

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Please fill out the below information to set up a time to pick up your child's medication on either May 31st or June 1st. I am available from 8:45am-4:15pm on both days. If neither of those times work please call me at 314-415-6110.

Child's First and Last Name

I would like my child's medication:

To be picked up by myself or another adult (choose date and time below)

Sent home in back pack on June 1st, child MUST be a car rider (no exceptions)

To be disposed of in the health clinic

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My child is attending summer school, I would like the medication (if applicable) :

To be picked up by myself or another adult (choose date and time below)

Sent home in back pack on June 1st, child MUST be a car rider (no exceptions)

To be transferred to the summer school location by the school nurse

Clear selection

I will be picking up my child's medication on:

May 31st

June 1st

Clear selection

What time? (Please choose a time between 8:45am and 4:15pm)

Time

Any comments or questions?

Submit

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