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.

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.

This form is required for Self-Administration of Asthma Inhaler Medication or other potentially life threatening illness.

This three page document is required to allow for administration of Epi-Pen. Also included is the Emergency Health Care Plan.

If you would like your child to sit at the Peanut/Tree Nut Free Table

please fill out this form.