Medication Form

Please use this form if your child has been prescribed a medication by a pediatrician and has been allowed to return to school.  You may also use this form (without a physician’s signature) if you would like staff to apply sunscreen and/or bug-spray) Please be sure that you have administered the first dose of medication at home at least 12 hours prior to returning.

Illness and Medication Policy

Occasionally, your child will not feel well. Your child should not come to the center if they exhibit any condition on the list below.  Also, we will call you to pick up your child if he or she exhibits these symptoms.

  • Contagious illness, such as pink eye, etc.
  • One or more episodes of vomiting
  • Persistent diarrhea
  • Cold with a discharge (indicating infection)
  • Rashes or skin lesions without an obvious cause or without a health practitioner’s diagnosis
  • Temperature of 98.8 to 100 degrees or higher (not fever free without use of medication)

If we call you to come and pick up a sick child, you must make those arrangements immediately.  Your child may not return to the center until:

  • They are symptom free for 24 hours without medication
  • Are rested and alert, or have a doctor’s note with no restrictions stating that the condition is not contagious
  • Your child must be fever free WITHOUT MEDICATION for 24 hours before returning to the center.

We will post notices alerting you to contagious illnesses that have been reported to us.  Accidents or incidents will be documented on a form, which requires your signature.

Any and all health forms including Medication Authorization, Health Inventory, and Exclusion Notices that require a physician’s signature should be signed by a physician that is not related to the child.

Medication: Please remember, it is illegal for us to administer medication without the proper authorization.  Authorization procedures are as follows:

  • Obtain a Medication Authorization form either from the center or on our website.
  • The form must be completely filled out and signed.
  • A Health Practitioner’s signature is required for us to administer ANY medication, even over-the-counter medications such as Tylenol. This may not be signed by a physician related to the child.
  • Please hand any medication to a staff person. Licensing requires we keep all medication in a locked container.
  • Medications must be in a container labeled by the pharmacy or physician, with child’s name, dosage, and expiration date.
  • Please give your child the first dose of medication at home at least 12 hours before they return to watch for any possible reaction.


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