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Health and Medication Forms

The library to the right contains the required health forms for students. All students MUST have the MD Immunization Acknowledgement on file. Please note that other physician forms may be attached, but this specific signed form is required.

Any student who will require medication - prescription or over the counter - kept at school will need the Medication Authorization on file. Please refer to your Handbook for specific information regarding the school's Medication Policy.

No medication, prescription or over-the-counter, can be accepted or administered without written and complete authorization orders

FROM AN AUTHORIZED HEALTH CARE PROVIDER


An authorized health care provider must complete and sign the ADW Medication Authorization for all medication. This includes over the counter medication (such as Advil, Tylenol, Neosporin, Benadryl, allergy medication, etc.) as well as prescription medication.

If a child needs to keep any allergy medication (Inhaler, Benadryl, EpiPen, etc.) at school, we must have ADW Forms on file with the medication. You may print these forms from the school website at any time.

Please note:


  • Even if a child needs medication only for a temporary condition, we also MUST have authorization on file. This authorization ideally should be in the form of the Medication Authorization Form however a physician may use office stationery/ prescription pad in lieu of completing Part II as long as the note includes student name, diagnosis, medication name, dosage, and time of administration, duration of medication, side effects, physician signature and date. Incomplete documentation cannot be accepted.
  • All medication must be stored in the original container and labeled with the student’s name. This refers to both prescription and over the counter medication.
  • Medication must be delivered to the school office by an adult. Students may not carry any medication to school at any time. The only exception is students who have proper documentation to self-carry inhalers or auto injectors.

Please understand that without proper orders, we cannot administer any medication to your child.
Parents are always welcome to come administer the medication, but the Office Staff cannot do so.

Health Forms

this is required for all students upon enrollment


For students requiring medication at school: