Documents and Forms

Medication Policy Guidelines:

*Medication control form must be completed and signed by parent and physician for a student to be administered medication at school (one form for each medication; new form each year)

*Medication must be in properly labeled bottle (extras can be obtained from the pharmacy for school use when the prescription is filled) and must be transported to the school nurse by parent/guardian or designated responsible adult.

*Medication will not be administered when school is dismissed prior to 12:00pm unless prior arrangements are made by parent or guardian.

*Students are not to carry and/or administer ANY medication (prescription or over the counter) at school except the following:

-An inhaler, epinephrine auto injector (EpiPen) or other emergency medications, when the following conditions are met:

• Completed Medication Control Form (new each school year) is signed and completed by parent and physician
• It is noted on the form that the student will carry and self-administer the medication

Please contact Aimee Seidel, RN, IMPS Nurse with any questions (906-779-2626)

Medication Control Form

Authorization Form

Fluoride

Fluoride FAQ

FERPA FORM