Administration of Medicines/Monitoring of Medical Condition
Child’s Name: __________________ ____
Date of Birth_________________________
1) Name: ________________________
2) Name: ________________________
3) Name: ________________________
4) Name: ________________________
Child’s Doctor: ______________________
Phone: _________________ _
Diagnosed condition: ___________________________________
Prescription details: ____________________________________
Is the child to be responsible for taking the prescription him/herself?
Description of medical condition:
What action is required: ____________________________________ _______
I/we request that the board of management authorise the taking of prescription medicine during the school day as it is absolutely necessary for the continued well being of my/our child. I/we understand that the school has no facilities for the safe storage of prescription medicines and that the prescribed amounts be brought in daily. I/we understand that we must inform the school/teacher of any changes of medicine/dose in writing and that we must inform the teacher each year of the prescription/medical condition. I/we understand that no school personnel have any medical training and we indemnify the board from any liability that may arise from the administration of the medication.
Parent/Guardian _________________________ Date____________________ _____
Parent/Guardian _________________________ Date________________________ _
This policy was reviewed on 23rd February 2012 and will be reviewed again on .
Rev Jane Galbraith (Chairperson)