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2020-21 Administration of Medicine at School Form

Please complete the form below. Required fields marked with an asterisk *

The following is Arendell Parrott Academy’s current policy regarding the administration of medication during school. This policy is consistent with current policies recommended by the Department of Health and Human Services, Public Schools of North Carolina. If your child must have medication of any type given during the school day, including over-the-counter drugs (such as Tylenol, ibuprofen, Midol, cold medicine, cough medicine/drops, Pepto-Bismol, etc), you have the following choices:

  1. Please download and print the medication form, take the form to your child’s doctor, have him/her complete the form by listing the medication(s) needed and dosage instructions, then complete items below and upload the completed form where indicated. This form must be completed by the physician for both prescription and over-the-counter drugs. The form must be signed by the physician. Prescription medicines must be brought to school in a pharmacy-labeled bottle. Over-the-counter drugs must be received in the original container and will be administered according to the doctor’s written instructions.
  2. You may discuss with your doctor an alternative schedule for administering medications outside of school hours.
  3. You may come to school and give the medication to your child at the appropriate time.

School faculty and staff will not be allowed to administer any medication to students unless the school has received a medication form properly completed and signed by both physician and parent, and the medication has been received in an appropriately labeled container. To guard the safety of your child and to insure that medications are distributed appropriately, there will be no exceptions to this policy.

If you have questions about the policy or other issues related to the administration of medication in the schools, please contact Mrs. Anne Fields at 252-522-0410, ext. 294 or afields@parrottacademy.org.

Thank you for your cooperation.

Anne Fields

Health Services Coordinator

Student's Grade*
Select the grade of your student as of August 2020
Answer Required
Please upload physician signed Request for Prescription and OTC Medication form here*
Link to form is in #1 above
Answer Required
or drag it here.

Parent’s Permission:

I hereby give my permission for my child (named above) to receive medication during school hours. This medication has been prescribed by a licensed physician. I hereby release Arendell Parrott Academy and their agents and employees from all liability that may result from my child taking the prescribed medication

I agree to the above statement*
Answer Required