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December 1, 2016
Medical Alert Form and Request for Administration of Medication at School
n order to meet your child’s health needs at school, we appreciate you taking the time to provide updated medical information. You have previously indicated that your child has a medical condition that makes it necessary for him/her to take medication at school on a regular or emergency basis or that your child has a medical condition that may require an emergency intervention or a response plan.
Medical Alert Form
Please access the medical forms here.
Alternatively, you may pick up a copy of the package at our Pearson Office. Please provide the relevant information on your child including their diagnosis and the name of your doctor. Please complete the section regarding what to do if your child has an “attack” at school, if your child has a condition where this could occur; for example, a child who has epilepsy, severe allergies, diabetes or asthma.
Please sign at the bottom of the first page if you are requesting medication to be given at school.
Request for Administration of Medication at School
Section A is to be completed by your physician/licensed medical practitioner if they have recommended medication to be taken at school either on a regular basis or on an emergency basis. Section B is to be completed by the parent/guardian.
Any changes in medication or dosage will require an updated form before medication can be administered.
Once you have completed this form please return it to your school as soon as possible. We will review the information and develop a plan for your child. If you have any questions please call the school.