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Medication Forms


 

CONSENT FOR TAKING MEDICATION AT SCHOOL

K-8TH GRADE STUDENTS

  1. Authorization to Administer Medicine (Spanish version: Authorization to Administer Medicine Es) OR
  2. Carry and Self-Administer Asthma/Allergy Medicine (Spanish version: Carry and Self-Administer Asthma/Allergy Med Es)

HIGH SCHOOL STUDENTS

A high school student who needs to take medicine at school or a school-sponsored activity, may be authorized to possess and self-administer their own medication except controlled medications, in accordance with district medication policies. Click here for medication policy details. 

  1. Carry and Self-Administer Medicine - High School (Spanish version: Carry and Self-Administer High School Es) OR
  2. Authorization to Administer Medicine (Spanish version: Authorization to Administer Medicine Es

 

*DON’T FORGET TO HAVE YOUR PROVIDER FILL OUT A HEALTHCARE ACTION PLAN FORM, ALONG WITH THE MEDICATION FORMS, IF YOUR STUDENT HAS THE FOLLOWING CONDITIONS: MIGRAINES, SEIZURES, ANAPHYLAXIS ALLERGIES, ASTHMA, DIABETES, or any other condition that may need further medical attention during the school day.*

 

PSD does not unlawfully discriminate on the basis of race, color, creed, religion, national origin, ancestry, sex, sexual orientation, gender identity, gender expression, marital status, veteran status, age or disability in access or admission to, or treatment or employment in, its programs or activities. A lack of English speaking skills will not be a barrier to admission or participation.