Verification Of Student Admission Information (For Student Residing With Parent Or Guardian)/proof Of Residency Form (Page 12 of 13) in pdf

Student’s Name:

Grade:

RED OAK I.S.D. MEDICATION GUIDELINES:

Updated: 4-2015

Parents/guardians should make every effort to give required prescription and non-prescription medications to a student

at home. When this is not possible, the ROISD staff may assist in the administration of medication during school

hours, subject to the following rules.

Parent permission: The parent or legal guardian must provide the school with written permission to have the school

administer the medication. This note should include the name of the medication, the dosage, the time and dates to be

given, the student’s name, a parent’s signature, and the date signed. This note will remain in student’s file.

Prescription medications: All prescription medication is to be delivered to the clinic by a guardian or parent and must be in

original containers and be properly labeled. A properly labeled prescription is one with a pharmacy label stating the

student’s name, name of medication, dosage to be administered, doctor’s name, and the date prescription filled. To

protect the students, staff shall not administer medication in a dosage that exceeds the recommended maximum in the

Physicians’ Desk Reference. This request is valid for current school year only. All controlled substances (example,

Ritalin,) must be picked up and delivered by responsible adult. . (Exception is “self medicated student” as with

inhalers or diabetes medication).

Non-prescription medication. Over the counter medications will be given upon a written request by parent or legal

guardian for five (5) consecutive days. All “over the counter” medications must be delivered by a responsible adult. No

medication will leave the nurse’s office in the hands of a child. In addition all “over the counter” medications must be

properly labeled, in the original container and non-expired. If needed over 5 (five) consecutive days a Physician’s

authorization to continue the medication will be required.

Special agents, such as herbs, vitamins, amino acids or homeopathic remedies:

Only if required by the Individualized Education Program or Section 504 plan of a student with disabilities, is age

appropriate and provided by the parent.

Such substances must be presented to the nurse in the original container and must not be older than the expiration

date on the container. In addition, the following shall be submitted to the District before any herbal substances or

dietary supplements are administered to a student:

A physician description of substance’s content and possible adverse effects;

The parent’s written request to administer the substance; and

Specific instruction for use of the substance.

Special note: The school nurse will not be obligated to administer any non FDA approved substance for which she has

no training, knowledge or familiarity (as in accordance with the Texas Board of Nurse Examiner regulations).

Expired medication: the school will not dispense any expired medications.

Transportation of medication: All medications are to be delivered by an adult to the nurse. No medication will be carried

home by your child. (Exception: self medicated students) (See “Self medication below) All medication must be picked

up and delivered by a responsible adult.

Locked cabinet: All medication will be stored and locked in the clinic or office area as designated by the principal or nurse in

charge. The campus nurse/nurse assistant (or designee of the principal) will dispense all medications and it is the

responsibility of the student to report to the clinic to take his/her medication at the proper time.

Unused medication: All unused medication will be destroyed one week after the dosage date or at the end of the year, unless

picked up by responsible adult. A parent or guardian must deliver and pick up all medications, including controlled

substances; such as Ritalin…this is required due to increasing drug problems and selling of controlled substances.

Field trips: Medication policy and regulations will be observed on all off-campus trips. Persons responsible for such trips

will observe and communicate these regulations to students and parents.

Self medication: students shall not administer any medication to themselves except with a physician’s order stating the child

needs to carry this medication with him/her at all times. The student must demonstrate the proper administration of the

medication and show responsible behavior on carrying his/her medication at all times…otherwise this privilege can be

taken away and they will have to see the nurse for treatment.

Documentation: The school nurse shall keep a separate Medication Administration Record for each student, which includes

name, medication, dosage, times to be given, signature of person administering the medication and parent permission.

UPDATE PHONE NUMBERS AND ADDRESSES WITH SCHOOL PERSONNEL AS NEEDED.

Read by ______________________________________ date: _________________________

Verification Of Student Admission Information (For Student Residing With Parent Or Guardian)/proof Of Residency Form Page 12

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