A parent or guardian must bring any / all medications to the school and fill out a medication administration form. Students are not allowed to carry any medications with them at school or on the bus. This includes any over the counter medication, for example; cough drops, Tylenol, etc. If you would like your child to have any OTC medication left in the clinic, you must bring to school with a completed medical authorization form.
To give us authorization to give your student their medication you will need to complete the Medication Authorization Form. You may print it, complete it, and bring it in or you can pick one up to complete in the clinic. A separate form is required for each individual medication.
If your student requires an inhaler and/or an Epi-pen you will need to complete the appropriate form.
For your student to be permitted to carry their inhaler and/or Epi-pen on their person, their physician will need to complete the section of our form advising us of their authorization. If the student will be carrying their inhaler and/or Epi-pen on their person, we ask that you also provide the clinic with a backup in case one is needed.
Medication Request Form
Shiloh Middle School Clinic
Phone: 770-736-4030
