{"id":519,"date":"2026-09-21T10:10:26","date_gmt":"2026-09-21T14:10:26","guid":{"rendered":"https:\/\/www-lms.stjohns.k12.fl.us\/clinic\/accessible-docs\/non-prescription-medication-parent-guardian-permission-for-student-to-self-administer-pdf\/"},"modified":"2026-09-21T13:41:23","modified_gmt":"2026-09-21T17:41:23","slug":"non-prescription-medication-parent-guardian-permission-for-student-to-self-administer-pdf","status":"publish","type":"savoy_document","link":"https:\/\/www-lms.stjohns.k12.fl.us\/clinic\/accessible-docs\/non-prescription-medication-parent-guardian-permission-for-student-to-self-administer-pdf\/","title":{"rendered":"Non-Prescription-Medication-Parent-Guardian-Permission-for-Student-to-Self-Administer.pdf"},"content":{"rendered":"<h1>Health Services Parent Permission for Student to Self-Administer Non-Prescription Medication<\/h1>\n<p>ST. JOHNS COUNTY SCHOOL DISTRICT<\/p>\n<p>Rev. 06\/2022<\/p>\n<h2>Overview<\/h2>\n<p>School Board Policy 5.15 \u2013 Administration of Medication during school hours, states that \u201call prescription and non-prescription medication administered by the school at the elementary, middle and high school level must be directed by a physician who has determined that a student\u2019s health and well-being requires medication during school hours. All non-prescription medication in the possession of students at the middle and high school, not administered by the school, requires written permission from the parent to the school.\u201d<\/p>\n<p>To comply with School Board Policy 5.15, parents\/guardians are responsible for obtaining the Medication Authorization Form to be filled out by the physician if medication will be given by the school. For those students carrying non-prescription, non-emergency medications, the parent\/guardian is responsible for completing the Parental Permission Form at the bottom of this letter.<\/p>\n<h2>Policy Details<\/h2>\n<p>School Board Policy 5.15 \u2013 Administration of Medication During School Hours, states that a student at the middle and high school level may carry a non-prescription, non-emergency medication on his or her person while in school with approval from his or her parent\/guardian.<\/p>\n<p>Over-the-counter medications must be in the original container.<\/p>\n<h2>Permission Form<\/h2>\n<p>I give permission for the below named child to carry and self-administer his or her own non-prescription, non-emergency medication. I understand that my child may not share his or her medication under any circumstance and that a copy of this permission form must accompany the stated medication. I understand that if there is inappropriate behavior or a safety risk, the privilege of carrying his or her medication will be rescinded.<\/p>\n<table>\n<thead>\n<tr>\n<th scope=\"col\">Student Name<\/th>\n<th scope=\"col\">Grade<\/th>\n<th scope=\"col\">Homeroom<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>[Student Name]<\/td>\n<td>[Grade]<\/td>\n<td>[Homeroom]<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Name of non-prescription, non-emergency medication: [Medication Name]<\/p>\n<p>Reason for medication: [Reason]<\/p>\n<p>Parent\/Guardian Signature: ______________________<\/p>\n<p>Parent\/Guardian Printed Name: ______________________<\/p>\n<p>Date: ______________________<\/p>\n<p>I understand that I am not to share my medication under any circumstance and that a copy of this permission form must accompany the above medication.<\/p>\n<p>Student Signature: ______________________<\/p>\n<p>Student Printed Name: ______________________<\/p>\n<p>Date: ______________________<\/p>\n","protected":false},"author":429,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-519","savoy_document","type-savoy_document","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www-lms.stjohns.k12.fl.us\/clinic\/wp-json\/wp\/v2\/savoy_document\/519","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www-lms.stjohns.k12.fl.us\/clinic\/wp-json\/wp\/v2\/savoy_document"}],"about":[{"href":"https:\/\/www-lms.stjohns.k12.fl.us\/clinic\/wp-json\/wp\/v2\/types\/savoy_document"}],"author":[{"embeddable":true,"href":"https:\/\/www-lms.stjohns.k12.fl.us\/clinic\/wp-json\/wp\/v2\/users\/429"}],"version-history":[{"count":0,"href":"https:\/\/www-lms.stjohns.k12.fl.us\/clinic\/wp-json\/wp\/v2\/savoy_document\/519\/revisions"}],"wp:attachment":[{"href":"https:\/\/www-lms.stjohns.k12.fl.us\/clinic\/wp-json\/wp\/v2\/media?parent=519"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}