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Parental agreement to administer medicine

All medicines must be prescribed by a GP and clearly labelled and given to the school office.

If the dosage requirement is 3 times daily then the medication will not be accepted at school as the middle dose can be given by parents/carers after school.

Year Group*


The above information is to the best of my knowledge accurate at the time of writing and I give my consent to school staff administering the medication in accordance with the school and the Education Department’s policy.

The school will be notified immediately, of any changes to the above.

If more than one medicine is to be given a separate form should be completed for each.