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Medication Forms for In Person Instruction
Posted 10/20/20

In preparation for the hybrid model going into effect, we want to make sure that if your child requires prescription/asthma/epi-pen medication, and/or over the counter (OTC) medication during on-site school hours, we have the documentation complete.  If this applies to your child(ren), please complete the below instructions.

  • Select the form(s) - (links are below) and have it/them completed by your child’s doctor for prescription medication, asthma medication/epi-pens, and by you, for over-the-counter medication(s).
  • Drop the completed forms and medication(s) off to the office; email/call the office to make an appointment. Or, you can email the forms and drop off the medication later.
  • Email the office a current picture of your child’s face so that we can include it on their Individual Health Plan. You can also bring in a picture when you drop off the forms/medications.  


Once the office receives your documents, we will create your child’s Individual Health Plan that goes along with their medication(s).  

Prescription medication Form

Asthma Inhaler/Epipen Medication Form

Permission to Administer Over the Counter Medicine (OTC) Form

If you have any questions, please do not hesitate to reach out to the office.


See you soon,

Julie Lawrie, Secretary,


Marlo DeBiasse, Asst. Secretary,