• Prescription medication must be in the original container as dispensed by the pharmacist. The label must include the student’s name, name of medication, dosage and have current date.
  • Over-the-counter or non-prescription medications must be in the original packaging with all directions, dosages, contents, and proportions clearly indicated. Please provide a doctor’s note with instructions and dosage.
  • All medications, including refills, must be brought to school by the parents and left with authorized school personnel. Students are not to have medications in their possession. 
Child's Name *
Child's Name
dose / time given / etc.
NAME
Date
Date