Request To Administer Medicine Form (Page 2 of 2) in pdf

LEANDER INDEPENDENT SCHOOL DISTRICT

REQUEST TO ADMINISTER MEDICATIONS

PROCEDURES

MEDICATION

Medication may be administered at school with:

1. A parent or guardian’s written request that there is a need for medication during the school day and the parent brings the medication

to the clinic. This includes both prescription and over-the-counter medications.

2. No medication is provided by the school.

3. Medication must be kept in the school clinic and administered by the school nurse, health assistant or school employee.

4. No medication will be sent home with a student. Parents/Guardians must pick up all medications whether prescription or over-the-

counter.

5. Over-the-counter medication must be in the original bottle or box with the label intact and non-expired. Dispensing directions regarding

age, dose and frequency will be strictly adhered to. Request to alter the standard dosage or frequency on over-the-counter medication

must be accompanied by a physician’s written note and signature.

6. Prescription medication must be in the original container and non-expired. It must be properly labeled in a prescription bottle/box with

the student’s name, medication name, directions for dispensing the drug and written by a physician licensed to practice in the United

States. A physician’s signature is required for any dosage or medication change on prescription medication. All PRN (as

needed) prescription medications will need a physician’s signature.

7. Short-term prescription medication can be administered for up to 10 consecutive days without a physician’s signature. The prescription

label can be no more than 7 days old upon receipt by the school clinic. A written request/signature from a physician must be obtained

if the medication needs to be administered for more than 10 days.

8. Medications (controlled substances) will be counted by the school nurse or the health assistant upon arrival at school and documented

as to the number of pills received. Narcotic pain medications prescribed for temporary medical conditions will not be stored or

administered in the clinic. Medications must be delivered by the parents/guardians.

9. Medications prescribed or requested to be given three times a day or less will not be given at school unless a specific time of

administration during school hours is prescribed by a physician.

10. A student may be allowed to self-administer inhaled asthma medication, an Epi-pen, or diabetes treatment ONLY if the following

conditions have been complied with:

a. Written permission from the physician allowing the student to self-medicate or treat

b. The nurse has counseled the parent and the student on the school’s inability to monitor the student’s health condition

during the school day while self-medicating or treating.

c. The student complies with all campus safety policies.

11. No district employee will administer herbal substances, anabolic steroids or dietary supplements except as prescribed by a physician if

it is required by the IEP or Section 504 plan of a student with a disability. Medication must be provided by student’s parent or guardian.

Reliable information must be given by the physician regarding the safe use of the product including side effects, toxicity, drug

interactions and adverse effects.

***In accordance with the Nurse Practice Act; Texas Administrative Code, Section 217.11, the Registered Nurse and the Licensed Vocational

Nurse have the responsibility and authority to refuse to administer medications that, in the nurse’s judgment, are contra-indicated for

administration to the student.***

Request To Administer Medicine Form Page 2