Prescription medication that is not in your child's name will not be administered.
If YES please ensure that pharmacy prescription sticker on the box or container is clearly visible. Prescription medication without this sticker will NOT be administered.
If NO please ensure that you have a letter from your doctor confirming that we can administer the medication.
This must be signed by your doctor or other qualified person.
The date this course of medication was started.
In the case of multiple dosages / administrations of medication please specify in the "Special Instructions" section below.