Medication Authority

This form must be signed by the parent or carer who provides the medication.

Schools will only administer medication to students with the signed authority of the parent or carer. Please complete the sections relevant to the student’s health support needs. If additional information is required, please supply it with this form.

Important: Wherever possible, medication should be scheduled outside school hours. For example, medication required three times daily is generally not needed during the school day—it can be taken before and after school and before bed.

Medication to be administered during school hours

Requirements:

1. Complete the online form or or download a copy here.

2. Please email all required documentation to bundoora.sc@education.vic.gov.au as soon as possible.

• For students with asthma, please also provide a completed Asthma Action Plan

• For students with anaphylaxis, please also provide a completed ASCIA Action Plan for Anaphylaxis

Medication to be administered during school hours

Please ensure that all medication to be administered at school:

• Is in its original packaging

• The pharmacy label matches the information included in this form

Monitoring effects of medication

School staff do not monitor the effects of medication and will seek emergency medical assistance if concerned about a student's behaviour following medication.

Privacy statement

We collect personal and health information to plan for and support the health care needs of our students. Information collected will be used and disclosed in accordance with the Department of Education and Training's privacy policy which applies to all government schools and the law.