MEDICATION AUTHORIZATION
This form must include the student's name, medication, dose, time, and signed by provider and parent
What is the Medication Authorization Form
Medications must be brought to the school office by this person.
Who is an adult?
Emergency medications, except for this type, must be kept in a secured but unlocked location.
What are seizure rescue medications?
Only these individuals are authorized to administer medications to students.
Who are trained and designated employees?
Students from Kindergarten to Grade 12 may carry and self-administer these types of medications with the appropriate forms.
What are asthma medications, allergy medications, and diabetes medications?
Medication Authorization Forms can be carried over from one school year to the next? YES or NO?
No - a new authorization is valid for the school year. A new form is required at the beginning of each school year.
Prescription medications must be in this type of container.
What is a pharmacy-labeled container?
Seizure rescue medications and all other medications except certain emergency ones must be stored in this type of location.
What is a locked cabinet, drawer, or box?
The designated employee must document medication administration on this form and documentation system.
What is an approved medication administration log and schoolcare record?
Students in Kindergarten through 6th grade may not carry or self-administer any medications other than these.
What are asthma medications, allergy medications, and diabetes medications?
The form required for administering medication must be completed and signed by these two parties.
Who are the healthcare provider and the parent or guardian?
Emergency Medication that can ONLY be taken in by the RN
What are Rescue Seizure Medications
Route, Medication, Time, Student, Dose, Documentation
What are the 6 Rights of Medication Administration?
Documentation of medication administration must also include these key details?
What are the employee's initials, and time of administration?
Students in grades 7 through 12 may carry this amount of medication if authorized and with what form?
What is a one-day dosage and a self administration medication authorization form .
This form is valid for one year or until there is a change in the student's medication or dosage.
What is the Medication Authorization Form?
Over-the-counter medications must be in this type of packaging.
What is the original packaging with the student’s name and dose written on it?
Medications that MUST be locked at all times
What are ALL non-emergency medications (except rescue seizure medications) ?
This must be documented along with the administration of medication.
What are the student’s absences, school breaks, and any periods when the medication may have run out?
This type of medication cannot be self-carried by any student.
What are controlled substances?
The Health Aide must have and complete all of the four forms when taking in medication from the parent
1. Completed/signed CCSD Medication Authorization Form
2. Medication in labeled prescription bottle or original container
3. CCSD Medication Checklist
4. CCSD Medication Log
This type of medication must be disposed of by the district nurse at the end of the school year if not picked up by the parent or guardian.
What is any remaining medication on school premises?
This type of medication must be disposed of at the end of the school year if not picked up by the parent or guardian.
What is any remaining medication on school premises?
If a medication is not administered within this time frame before or after its scheduled time, the district nurse must be contacted for approval.
What is within 1/2 hour before or after the scheduled administration time?
The form that must be provided for emergency medications like epinephrine must also include this plan.
What is the School Health Plan or Action Plan?