Medical Permission Form

MedicalPermissionForm

We understand that, from time to time, the administration of medicine to keep your child hale and healthy is necessary. Medicine prescribed by a doctor, with clear pharmacy labelling will be administered with your consent, direction and at the discretion of the headteacher. If you’re uncertain, please just give us a call!

The school will not give your child medication without this form being completed.

Full name*

DOB*

Class teacher*

Name of medication*

Method*

Allergy Medication

AntiBiotics

Asthma Pumps

Epi-Pen

Time*

Emergency contact name*

Emergency contact number*

Prescribing GP contact number*

Dosage instructions & timings*

Start date of course of medicine*

End date of course of medicine*

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