Crown Point Elementary School

       AR Tally    AR Test List      Cafeteria       Character Traits         Class Information       Class Supplies    Code of Conduct      County Calendar      Disclaimer

     Employee Information     Extended Day          Forms       Home Page        Media Center      Orientation          Parent Portal       PTA      Registration for School      Resources   

                              SAC           Safety Nets         School Calendar          School Clinic          Student Handbook        School Hours    Student Testing    Testing Dates    Teacher of the Year                                

Duval County Public Schools
Student Services
Parent Permission For The Administration Of Prescribed Medication

Student:                                                                              D.O.B.                                              School #                          

Name of the Medication:                                                                                          Doctor:                                             

Prescription Number:                                                                      Date of Prescription:                                              

I,                                                    , grant permission for the principal or the
              (Parent/Legal Guardian)
principal's designee to assist in the administration of prescribed medication for my child/legal ward,                                              .
                                                   (Student)
I certify that the prescribed medication is in its original container and that it is necessary, according to my doctor's instructions, for this medication to be provided during the school day, including when my child is away from school property on official school business.  I understand that this medication will be given only according to the directions on the label as prescribed by the doctor.

                                                                                                                                                                             
Signature of Parent/Legal Guardian                               
                        
Date

                                                                                                         
Teacher/Room#