Student Medication Form

Click here to print a copy of the  STUDENT TRIP MEDICATION FORM

Parent/Guardian: 

1. If you are sending ANY type of medication with your student, you need to fill out this form. 

2. Each bus box has standard over-the-counter medications and a first aid kit. There is no need to send any over-the-counter medications unless they are not listed here: 

• Acetaminophen (Tylenol) Ibuprofen (Advil) 
• Allergy Relief (Benadryl) Midol 
• Stomach Relief (Pepto Bismol) Tums 
• Motion Sickness (Dramamine) 

3. Items like inhalers and Epi-pens can be kept with the student. 

4. Write down all of the medicines the student is taking. 

5. Include the medication name, dose, directions for administration, and reason for taking for EACH medication sent with the student. 

6. ALL medications must be in their original bottle (prescription or over-the-counter) with the original label. (Prescription labels must be correctly labeled with the student’s name and the medication.) 

7. You may put multiple bottles in a Ziploc bag labeled with the student’s name.

8. Give this form and the medication to the Chaperone Chair upon arrival at the school.