Administration of Medication Consent Form

Please ensure any medicines your child needs in school are handed to an adult on the playground in the morning, or given directly to the school office.

Please make sure the bottle/box is clearly marked if the medicine needs to be kept refrigerated.

Please do not send medicines in your child’s bookbag.

The office team require this form to be completed to ensure your child gets the correct dose at the correct time.

Child's Name* Year Group* GP's name* GP's telephone number

Select one of the followingMy child will be responsible for the self-administration of medicines as directed belowI agree to members of staff administering medicines/providing treatment to my child as directed below or in the case of emergency, as staff may consider necessary

Name of medication* Required dose* Time medication should be administered* Special instructions Allergies Other medications being taken

In submitting this form, you are confirming you recognise that school staff are not medically trained.

The school cannot be held responsible if the medication is not administered on a particular occasion; parents are strongly encouraged to come into school and administer the medicine themselves.

Name of parent/guardian* Date*

Administration of Medication Consent Form

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