Medication Authorization Form - Wayne-Westland Community Schools - wwcsd 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the student's name, date of birth, school, teacher, and grade in the designated fields at the top of the form.
3. Next, have the physician or authorized prescriber complete their section. They should provide the name of the medication, reason for medication (if desired), and select the form of medication from options like tablet/capsule, liquid, inhaler, injection, nebulizer, or other.
4. Instruct the physician to specify the dose and time for administration at school. If there are any restrictions or side effects, they should describe them in the provided space.
5. The physician must also indicate any special storage requirements for the medication before signing and providing their contact information.
6. As a parent/guardian, complete your section by confirming that your child will receive this medication at school. Sign and date where indicated.
7. Finally, ensure that all sections are filled out correctly before submitting it to your child's school office.

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