Dear Parent/Guardian:

The following procedures should be followed when requesting school personnel to administer medication to your school child during school hours:

• The Union School District will cooperate with parents and their medical practitioners in giving prescribed medications when they must be given during school hours (e.g. failure to take such medication would jeopardize the health of the student or the student would not be able to attend school if the medication were not made available during school hours). To comply with a request, the parent or guardian must sign a district form giving written instruction for medication, permission for such administration, and relieve the Board and its employees of liability for administration of medication. The physician/dentist must also sign a district form(see attachment). The container for the medication, which is taken to school, shall be the container from the drugstore.
• The Parent and /or high school student should bring the completed medication forms and the medication to the school and give it to the appropriate school personnel (e.g. School Nurse, School Secretary or Building Principal). Send only enough medication to be taken at school for the duration of the prescription. Your pharmacist will, upon request, divide the prescription medication into two separate, labeled containers – one for home; the second for use at school. If the student is to only take one –half a pill, the medication should be cut at home.
• The medication shall be locked in a cabinet. Note: Prescribed asthma inhalers and epipens may be kept by the student and self-administered if the physician indicates this need in writing and considers the student sufficiently responsible. In addition, the physician should list any precautions to be followed on this form (the school nurse will inform the principal and appropriate others). The parent will also need to complete the asthma action plan and asthma inhaler self-administration agreement.
• School personnel will keep a record of the administration of medication and destroy unused medication which has not been picked up by the parent or guardian after the duration of the prescription.
• The parent/guardian of the child must assume the responsibility for informing the school of any change in the child’s health, or change in medication. A new medication form must be completed by the parent and physician with each change in medication or at the beginning of each school year.
• When available, the school nurse shall administer medication. In the absence or unavailability of the school nurse, the nurse will designate other appropriate personnel (RN, LPN) to be responsible for these duties. The school nurse will instruct or orient personnel designated to dispense any medication to any particular student.
• Non-prescription medications that may be given in a non-emergency situation are acetaminophen (such as Tylenol), tums, cough drops, Benadryl or ibuprofen, in accordance with the treatment protocol established by the school physician. All over the counter medications will be given by the nurse at her discretion. The parent must sign the authorization for over the counter medications on the student’s emergency information card and relieve the Board and its employees of liability for administration of the medications.
• A copy of the district medication forms have been attached for your convenience.
Please see the School Nurse or Building Secretary if you need additional forms. Thank You.


(Rev.3/10)