Crestwood Park - Administer Medicines on a Regular Basis

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Administer Medicines on a Regular Basis

Parental agreement for administering medicine on a regular basis for the academic year 2016/17.
This for is used for medicine left in school for continued use.
The school will not give your child medicine unless you complete and sign this form, the school does have a policy that staff can administer medicine

Name of Child:

Date of Birth:

Class:

Medical condition/illness:

Medicine

Name/Type of Medicine:

Review date:

Dosage and method:

Timing:

Special Precautions:

Are there any side effects that the school needs to know about?

Procedures to take in an Emergency:

Contact Details

Name:

Daytime Telephone No:

I understand that I must deliver the medicines (in their original container/packaging) to school and accept that this is a service that the school is not obliged to undertake.

I understand that I must notify the school of any changes in writing.

Relationship to child:

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Crestwood Park Primary School

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Administer Medicines on a Regular Basis

Medicine

Contact Details

Crestwood Park Primary School