To review the entire District policy on the use of medication, please read the entire policy located at the following link: 


The following Attachments are associated with Policy 210:

Attachment 1: Authorization for Medication at School - A parent/guardian and physician must complete this form for any medication that needs administered during school hours. 

Attachment 3: Parent Consent for Standing Order Medications - A parent/guardian must complete this form if they want their child to be able to have Tylenol, TUMS, or Benadryl administered during school hours.

Attachment 4: Authorization for Self-Administration of Medication at School - A parent/guardian and physician must complete this form if the student needs to carry the Albuterol inhaler or EpiPen on their person during school hours. 

Attachment 5 Student Contract To Carry Asthma Inhaler/Epinephrine Auto Injector - If the student is to self carry the Albuterol inhaler on themselves while at school, this additional form must be completed by the parent/guardian and student.

Attachment 6 Non-Aerosol Topical Sunscreen Use Form - A parent/guardian and student must complete this form if they choose to supply the child with non-aerosol topical sunscreen.

If your child requires medication during school hours, the appropriate form listed above is required BEFORE medication will be administered at school. The completed form is only good for the current school year. A NEW form must be completed at the beginning of each new school year.

Please call your school nurse if you have any questions.


SUNSCREEN PROTECTION - Non-Aerosol Topical Sunscreen Use Form

In October of 2018, the PA School Code was amended to include sun protection measures for students.

This allows for the use of non-aerosol topical sunscreen product by a student in school if:

  1. The product is approved by the Food and Drug Administration.

  2. The parent/guardian must submit a form allowing the student to use the topical sunscreen.

  3. The student must submit a form stating that they are aware of the proper use and safety precautions of the product and will handle it appropriately.

The school may rescind and/or restrict the use of sunscreen if the student does not follow the school rules and/or the student is unwilling or unable to keep the non-aerosol sunscreen product guarded from other students' use.

The school will provide written notice to the parent/guardian if sunscreen use has been rescinded or restricted.

The school will not supply the sunscreen and staff are not responsible for ensuring that the sunscreen is applied by the student.