Common Contracts
1 similar Parental Agreement for School to Administer Medicine contracts
ContractParental Agreement for School to Administer Medicine • October 9th, 2018
PARENTAL AGREEMENT FOR SCHOOL TO ADMINISTER MEDICINE The school will not give your child medicine unless you complete and sign this form, and the school has a policy that staff can administer medicine. Student Details Contact Details Name of Child: Name: Date of Birth: Daytime Telephone Number: Form: Relationship to Child: Medical Condition/Illness: Address: Medicine Details Name/Type of Medicine, Strength (as described on the container): Special Precautions : Date Dispensed : Any other instructions : Expiry Date : Are there any side effects that the school needs to know about? Agreed review date to be initiated by (name of staff member) : Self-Administration : YES or NO (delete as appropriate) Dosage and Method : Procedures to take in an emergency : Timing : Name and Phone Number of GP : I understand that I must deliver the medicine personally to Student Services Reception. The above information is, to be best of my knowledge, accurate at the time of writing and I give consent t
