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Medication authorization form

Fcps health form 2026

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The document is a Medication Authorization and Release Agreement for parents or guardians to request the administration of medication to students by Fairfax County Public Schools (FCPS) and associated health departments. It outlines the responsibilities of parents, the necessary procedures for medication administration, and the required signatures from both parents and physicians. The document emphasizes that medications should ideally be taken at home, specifies labeling requirements, and details the protocol for administering medications during school hours.

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Click ‘Get Form’ to open the fcps health form in the editor.
Begin by filling out the Parent or Guardian information. Include your name, daytime telephone number, and signature to authorize medication administration.
Complete the student’s details such as name, date of birth, school name, school year, and grade. Ensure accuracy for proper identification.
In Part II, specify any over-the-counter medications needed for symptoms like headaches or cramps. If applicable, have a physician complete and sign this section.
Provide detailed information about the medication including diagnosis, dosage, timing for administration, and any specific instructions regarding multiple medications.
Finally, ensure that all sections are completed before submitting. The Principal or designee will review and sign off on the authorization.

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2013	4.8 Satisfied (164 Votes)

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