Medication Authorization Form Page 2
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2SCHOOL MEDICATION RULES
Whenever possible we encourage medication doses to be scheduled
during non-school hours.
For those students who need medication at school, the following is required by Washington State Law (RCW
28A.210.260 and 270) and must be completed and on file BEFORE any medication may be given.
OVER-THE-COUNTER and NON-PRESCRIPTION MEDICATIONS/PRODUCTS
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Authorization for Administration of Oral Medications Form completed by both parent/guardian AND a
licensed health care professional with prescriptive authority.
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MUST be in original container labeled with the student’s name.
PRESCRIBED MEDICATION
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Authorization for Administration of Oral Medications Form completed by both parent/guardian AND a
licensed health care professional with prescriptive authority.
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Medication must be in a properly labeled container from the dispensing pharmacy. A pharmacy can
provide a labeled container for school upon request.
o Student’s name
o Name, Strength and Dose of Medication
o Time and Mode of Administration
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Provide no more than a 20 day supply.
PLEASE NOTE:
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Requests for the administration of oral medication are valid only for the medication listed and the dates
indicated. Requests for medication administration must be re-authorized each school year.
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Medication administered by routes other than oral, for example: ointments, eye drops, nasal inhalers,
suppositories, or non-emergency injections, may not be administered by school staff other than licensed
nurses.
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Epinephrine Auto-Injector is the only injector that school staff will be trained to administer to a student
who is susceptible to a predetermined life-endangering situation.
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All medications will be kept in the school office/health clinic unless otherwise directed by the Health
Care Provider. Medications stored in this area may not be available to the student during non-
school hours.
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Students in grades 7-12 may carry a reasonable amount (usually a one day dose) of medications that are
not controlled substances (eg. Narcotics, tranquilizers, psychotropic drugs). The same requirements of
signed/current authorizations and approval for self administration from the health care provider and parent
are needed. Any self carry meds must be approved by the school nurse.
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All students who need asthma or anaphylaxis medications may carry and self administer them if the health
care provider authorizes that and the school nurse determines the child can do so safely at school.
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Revocation of self carry/administration privileges may occur if the student is found to not manage or
administer the medications safely or within school or physician guidelines.
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It is the responsibility of the parents/guardians to assure that necessary emergency (rescue) medications are
available to their students after school hours and while traveling to/from and during after school events.
Thank you for your cooperation.
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