Medication Authority Form

This form should be completed by the student's parent/carer in consultation with their medical/health practitioner for all medication to be administered at school.  



Student Details


Medication Details

Duration


Heath Care Plans

Please upload your child's Health Care Plan.  Health Care Plans can be but not limited to;

  • ASCIA Anaphylaxis Action Plan

  • Asthma Action Plan

  • Diabetes Action/Management Plan for injection or pump


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Information for Parent/Carer

MEDICATION

Where possible, regular medication should be in a pharmacy prepared dosette (Webster pack).  Short term medication, liquid and topical prescribed medication must be administered from its original container,  bearing the original label and instructions, and before the expiry or use by date. All medication must have the student's name on the dispensed medication label.

Staff members are not permitted to administer the first dose of a new medication in the event that it may cause an adverse reaction.  The first dose of all medications must be administered by the parent/carer or a medical practitioner.

The school will not administer Paracetamol without the completion of this form as it may mask signs and symptoms of other illness or injury.

Parent/Carer are required to:

  • Maintain supply of medication to the school.

  • Complete a new Medication Authority Form if the student's doseage of medication changes (e.g. 20 mg to 30 mg).

  • Where dosage requirements vary from day to day (e.g for insulin, Rivotril), to provide a Health Care Plan from the prescribing qualified health professional advising the school that the parent/carer will be responsible for notifying the school of any adjusted doses.

  • Collect and dispose of any unused medication that is not longer required to be administered at school.

PRIVACY

The school collects personal information so the school can plan and support the health care need of the student.  Without the provision of this information the quality of the health support provided may be affected.  The information provided in this form may be disclosed to relevant school staff and appropriate medical personnel, including those engaged in providing health support as well as emergency personnel, where appropriate, or where authorised or required by another law. 

Information contained in this form is personal information and it will be stored, used and disclosed in accordance with the requirement of the Information Privacy Act 2014 and the Health Records (Privacy and Access) Act 1997.



Parent/Carer Authorisation

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