The following medication is to be kept in stock at the ISA Nurse's Office for the above mentioned student and will be administered as indicated below.
Medication #1
Medication #2
Should the student present with any of the above symptoms, the school will contact the child's parents.
I hereby grant permission for the School Nurse (if not available, the nurse's delegate) to administer the above-mentioned prescription medication to my child according to the information provided above.