Please read the "Greetings from the Health Room"  letter from our school nurse.

PARENT INFORMATION ABOUT EPINEPHRINE PROCEDURES

This form must be on file in the health room or in an other approved location. The parent or guardian is responsible for obtaining the physician's statement in part II. A new form must be submitted to the school each school year and whenever there is a change in the dosage or a change in the conditions under which epinephrine is to be injected.

Please print, sign, have a physician/provider complete and sign, and return the Authorization for Anaphylaxis Action Plan. Please call the Health Room 703-426-1010 to schedule a drop-off appointment.

Epinephrine may be given in school, during school-sponsored activities only with both physician and parent or guardian-signed authorization.

PARENT INFORMATION ABOUT INHALER PROCEDURES

This form must be on file in the health room or in an other approved location. The parent or guardian is responsible for obtaining the physician's statement in Part II. A new form must be submitted to the school each school year and whenever there is a change in the dosage or a change in the conditions under which inhaler is to be used.

Please have a physician/provider complete and sign the Virginia Asthma Action Plan. Also, print and sign the FCPS Authorization for the Virginia Asthma Action Plan. Please call the Health Room 703-426-1010 to schedule a drop-off appointment.

Medication kept in the school will be stored in a locked area accessible only to authorized personnel unless approved for the student to carry it during school hours. If a student carries his or her own inhaler, a backup may be kept in the clinic.

PARENT INFORMATION ABOUT MEDICATION PROCEDURES

Medications should be taken at home whenever possible so that the student will not lose valuable classroom time or have a shortened lunch period. Any medication taken in school must have a parent or guardian-signed authorization; some medications also require physician orders. Medication must be kept in the school clinic or other school-approved location during the school day. The parent or guardian must transport medications to and from school, except a high school student may carry an over-the-counter medication to and from the school health room. No medication will be accepted by school personnel without receipt of completed and appropriate medication forms. All prescription medications, including physician's prescription drug samples, must be in their original containers and labeled by a physician or pharmacist. An over-the-counter medication must be in the original container with the name of the medication visible. The parent or guardian must label the original container with the following:

• Name of student
• Exact dosage to be taken in school (e.g. milligrams per tablet, milligrams per ml/cc)
• Frequency or time interval dosage is to be administered
• The first dose of any new medication must be given at home.

The parent or guardian is responsible for submitting a new form to the school at the start of the school year and each time there is a change in the dosage or in the time at which medication is to be taken.

Please complete, print, sign and return the Medication Authorization Form  Please call the Health Room 703-426-1010 to schedule a drop-off appointment.

All health-related authorization forms must be complete, printed, signed and return to the Health Room by scheduling an appointment by calling 703-426-1010.

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