Common Contracts
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Student Self-Medication AgreementAugust 16th, 2024
Students who are developmentally and/or behaviorally able, will be allowed to self-administer medication, subject to the following:1. This Self-Medication Agreement form must be submitted for all self-medication.● Self-administration of non-prescription medication requires this form and permission from a schooladministrator. Self-administration of non-FDA approved medication must also include a written order from a prescriber.● Self-administration of prescription medication requires this form, and permission from a schooladministrator and either a RN practicing in the school setting or a prescriber. Prescriber consent can be 2. All me● included on the prescription label or on this self-medication agreement form. dication must be kept in its appropriately labeled, original container as follows: Prescription labels must specify the name of the student, name of the medication, dosage, route, andfrequency or time of administration and any other special instructions.3. Sharing and/or b
