Policy and Procedures
Dispensing Policy & Procedure
Permission to Dispense Forms
MAF- Medical Administration Form
Please review the list of forms below and determine which, if any, apply to your child's individual needs. Download, complete carefully, and submit each of these forms.
A (MAF) must be submitted if your child needs to take medications as prescribed by a physician during school hours.
An (MAF) must be submitted if you would like your child to take any non-prescription medications during school hours.
An (MAF) must be submitted for a child who may experience an allergic reaction (bee sting and peanut allergy, to name two common allergic reactions).
The Clinic staff want to know exactly what symptoms to be aware of and how to proceed for your individual child's medical situation. This form, in addition to MAF, is needed in order to administer oral medications, injections (such as an epi-pen).
An (Asthma Health Management Plan and MAF ) must be submitted if your child requires asthma medication and he/she is permitted to carry and provide self-administration of this medication
Note: When picking up your child you MUST have a current picture ID and be listed on the check out card. Thank you.
Clinic contact information