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- Medical Forms & Dispensing Medication
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Dispensing Medication
Pupils requiring medication at school must have the written directions and/or school medication form completed by the family physician. This will identify the type of medication, the dosage, the purpose of the medication, and direct the school nurse to administer the medication as to the time at which the medication shall be administered according to the physicians’ order, and the length of time for which the medication is prescribed, as well as possible side effects. It must be sent in the original bottle with the name of the pharmacy and the medication written on it, along with a note from the parent giving permission to give the medication.
The school nurse should be advised of any drugs being taken by a child in school or at home, particularly those which might cause a change in behavior.
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Authorization for Medication
Please be reminded that the Hillsdale Board of Education, under state mandate, requires a physician's written order and parent signature in order to dispense any prescribed or over the counter medication to a student.
Medication Authorization and Nurse State Mandated Letter.pdf 170.2 KB (Last Modified on August 31, 2023) -
Plan de Tratamiento del Asma - Estudiante (Español)
FY20-ALA-Asthma-Action-Plan_Home_School_Spanish_V1 2021.pdf 53 KB (Last Modified on October 28, 2021) -
Self-Administration of Medication
This form is required for Self-Administration of Asthma Inhaler Medication or other potentially life threatening illness.
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Emergency Administration Of Epi-Pen
This three page document is required to allow for administration of Epi-Pen. Also included is the Emergency Health Care Plan.
Emergency Administration of Epi-Pen Packet Nurse 2023-2024.pdf 2.79 MB (Last Modified on August 31, 2023) -
PEANUT/TREE NUT FREE TABLE
If you would like your child to sit at the Peanut/Tree Nut Free Table
please fill out this form.