Medication Log printable pdf download

Medication Log

MECOSTA-OSCEOLA INTERMEDIATE SCHOOL DISTRICT

15760 190TH AVENUE, BIG RAPIDS, MI 49307

231-796-3543 FAX 231-796-3300

MEDICATION LOG

A school administrator, teacher, or the school employee designated by the school administrator

will dispense students’ medication. Written approval by the Supervisor will be necessary for

another employee to dispense medication. All medication must be kept in a locked, childproof

container. If a container is needed for your classroom, contact the administrator of the building.

MOISD policy for appropriate permission will be followed (see Appendix P).

If a

parent/guardian would like us to dispense non-prescription medication, a note (including date,

dosage, time of dosage and signature) from the parent must accompany that medication, giving

their consent, in addition to a physician’s signature with the order to dispense during school

hours.

All classroom teachers will keep a Medication Log for each student.

SAMPLE MEDICATION LOG

Student’s Name: ____________________________ Teacher/Class: _______________________

Medication: ___________________

Date

Time

Dosage

Dispensed by

Witness

Medication Log