Authorisation to Administer Medication Form >Authorisation to Administer Medication Form Authorisation to Administer Medication Form Student Name(Required) First Last Student DOB(Required) DD slash MM slash YYYY Class(Required)Transition to PreschoolAnisaCooindaKiahKintaAlchiraAthanorNautilusMithraSiriusName of Medication(Required) Dosage to be Administered(Required) Method of Administration(Required) Time to be Administered(Required)To be taken with food?(Required) Yes No If Yes, Before food or After Food(Required)Before FoodAfter FoodParent Guardian Name(Required) First Last Parent/Guardian signature(Required)Consent(Required) I consent to my child being administered this medication by an ISMS staff memberBy submitting this form, I am providing informed consent to Inner Sydney Montessori School to administer the listed medication above to my child. I also acknowledge that I must hand the medication to a Staff Member and advise if child is attending After School Care and whether medication is required during this time.
