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Medication Consent Form Information

Medication Administration Guidelines

If a student has a prescription or uses over-the-counter medication (OTC) that needs to be taken during school hours, on an overnight field trip, or at an athletic event or practice, the following must be done:

Medication Consent Form (available online)

  • A Medication Consent Form is required for all medication given at school.
  • Use a separate Union Academy medication consent form for each medication and for each child.
  • Each medication consent form must be signed by the parent/guardian and a physician. This is required for all medication given daily or on an "as needed" basis during school hours.
  • Each medication consent form must be filled out in its entirety. Consents with missing information will not be honored.
  • Verbal or over-the-phone consents will not be accepted; however, a faxed medication consent form will be allowed that is filled out appropriately.
  • It is recommended that the parent brings the medication consent form with the medication to the school health room.
  • All medication consent forms are valid for the current school year. All medications must be picked up at the end of the school year, and resubmitted for the next school year with an updated medication consent form. Medications not picked up by the last day of school will be discarded.

Supplying Medication

  • A parent/guardian must supply any medication s/he would like his or her child to receive (prescription or OTC). There will not be any “School Stocked” medication.
  • Prescription and OTC medications must be supplied in their original container. The dispensing directions must be on the outside of the container.
  • Please be mindful of expiration dates on medications before bringing them in. The school cannot dispense any medication that is out-of-date. If a medication expires while at school, the school will notify the parent/guardian to replace it.
  • A parent/guardian must deliver the appropriate medication to be dispensed to the school health room. Students may not carry or self-administer prescriptions or OTC medications without a self-carry consent form on file. (See Self-Carry Guidelines.)

Self–Carry Medication Guidelines

  • Emergency medications such as Inhalers, Insulin, Glucagon and EpiPens are the only medications that may be self-carried. Students may not carry or self-administer prescriptions or OTC medications while at school unless the medication is an emergency medication.
  • The Medication Consent form must be completed in addition to the Self-Carry Form.
  • A self-carry medication consent form must be filled out prior to a student being allowed to carry the medication.
  • The student must meet with the school nurse prior to self-carrying medication at school to review medication policy and administration guidelines.


Medication Consent Forms

Medication Consent and Self-Carry Form (English)

Medication Consent Form (Spanish)

Self-Carry Medication Form (Spanish)