Common Contracts
2 similar Parental Agreement contracts
Parental Agreement for School to Administer Prescribed MedicineParental Agreement • January 9th, 2019
Name of child: Gender: Male / Female Date of birth: Class: Medical diagnosis,condition or illness: MEDICINE Name/type of medicine (asdescribed on the container) Expiry Date Dosage & method of administration When to be given Special Precautions or otherinstructions. eg. with food etc Side effects that school must knowabout Can the child self-administer Y/N If YES, is supervision required? Yes / No Procedures to take in anemergency
Parental Agreement for School to Administer Prescribed Medicine The school cannot give your child their prescribed medicine unless you complete and sign this form, and the school has a policy that staff can administer medicine.Parental Agreement • October 7th, 2015
The above information is, to the best of my knowledge, accurate at the time of writing and I consent to school staff administering medicine in accordance with the policy. I will inform school immediately, in writing, if there is any change in dosage or frequency of the medicine or if the medicine is stopped. I understand that I must deliver the medicine personally to the school office and collect at the end of the day as required. I accept that this is a service that the school is not obliged to undertake.
