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Medical Forms If you have any questions regarding these policies and/or forms, you may contact Coelho's School Nurse at 508-761-7551 during school hours.
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| Medical Forms | |
| Health Services - Explains Attleboro School Department's and/or Commonwealth of Massachusetts;s policies regarding: Medication, Immunizations, Postural Screenings, Hearing/Vision Screening, Physical Exams, Orthopedic Injuries, Long Term Illness | |
| Parent/Guardian Letter - Letter from School Nurse to Parent/Guardian informing them of policies in place to ensure the health and safety of all children needing medicines during the school day. | |
| Written Parent/Guardian Consent for Medication Administration - must be completed, signed and given to the School Nurse before medications can be administrated. | |
| Medication Order - to be completed and signed by a Licensed Prescriber: Physician, Nurse Practitioner, or others authorized by Chapter 94C when medicine is prescribed for students that must be administered during school hours. Must be renewed as needed and at the beginning of each school year. | |
| Over the Counter Medications - This form authorizes the School Nurse to administer: Tylenol, Benadryl, Cough Drops (provided by parent) or Bacitracin to your child during the current school year. Consent my be withdrawn at any time by the parent. Must be renewed in writing annually | |
| Medication Administration Plan - Accompanies the Medication Order and Written Parent/Guardian Authorization Form. | |
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(pdf format - you may have to download Acrobat Reader to view these forms) |
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Return to:
Updated June 22, 2006 |
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