Skip To Main Content

Logo Image

Theodor Timmerman Elementary School

Logo Title

Medication Form

Medication Administration Form - English
If your child needs medication while at school, the school must have a "Request to Dispense Medication" form on file. The form must be signed by a parent or guardian. Prescription medication must be in the original  prescription container and be properly labeled with the student's name, the name of the medication, the route and duration of time the medication is to be given. Parents or guardians may not alter the dosing orders of the physician.  Non-prescription medication must be in the original container and must be age appropriate. (No adult medicine will be given to a student under age 12 unless prescribed by a physician.) This form must be updated yearly and be kept on file at the Nurse's Office.