Mill Valley School District

Providing excellent education

If your child will require medication at school, please do the following:

·    Complete a Medication Authorization Form, and have it signed and dated by the child’s doctor.  The form must specify the name of the medication, the dosage, and when it is to be given.  A new form is required at the start of each school year.

·    If the student will carry an Epi-Pen or asthma inhaler, complete the permission to carry section of the Medication Authorization Form.

·    Put medication and signed form in a gallon-sized ziploc bag with the child’s name on it and deliver in person to the administrative assistant at the school office.  Do not send with the student.  Parent/guardian needs to be there in person in case there are any questions.

·    PLEASE NOTE, this procedure applies for both prescription medications and over-the-counter medications, such as Tylenol, Advil or Benadryl. 

·    Medication WILL NOT be given at school until/unless this procedure is followed.  In the event of an emergency, staff will call 911.

If your child requires care for Asthma, Severe Allergy, Seizure or Migraine, the school office will also require a completed Action Plan in addition to the Medication Authorization Form.  The plan must be completed by the child’s doctor and provide specific actions to be taken in the event that your child needs care.  Print out the appropriate plan(s) below and take to your child’s doctor for completion.  Return the completed plan to the school office as soon as possible.  Do not send with the student.  Parent/guardian needs to be there in person in case there are any questions. 

·    Asthma Action Plan

·    Severe Allergy Action Plan

·    Seizure Action Plan

·    Migraine Action Plan

If you have any questions about care for your child while at school, feel free to contact Mill Valley School District Nurse Nakae, R.N. at 415-389-7768 or nnakae@mvschools.org. 


 
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