Board of Education

Matthew R. Clegg, President
Tracie H. West, Vice-President
Charles Smith
Melanie D. Chambless
William T. Hutto, Jr. / / Administration
Dr. Karen T. DeLano, Superintendent
Dr. Dennis Veronese, Assistant Superintendent
Dr. Cristen P. Herring, Assistant Superintendent

Date ______

Dear Parents/Guardians of Students Attending Overnight Field Trips:

Medications to be administered during extended or overnight field trips are administered according to the guidelines of Auburn City Schools (ACS). Medication will only be administered to students who are diagnosed with a chronic or emergency condition as indicated in the student’s IEP, Emergency Action Plan (EAP), Individualized Health Plan (IHP), 504 Plan, or as prescribed by the medical provider.

Auburn City Schools complies with all applicable laws on issues of medication administration. To protect the health and well-being of our students and to remain in compliance with existing laws and guidelines, the following criteria must be met in order for medication to be administered to a student. No exceptions will be made.

·  The parent/guardian must notify the school nurse, at least two weeks in advance, if his/her child will be attending an extended or overnight field trip.

·  The parent/guardian must deliver the medication and all required forms to the school nurse at least one week before the trip. Students are not allowed to deliver any medications. The nurse must authorize all medication to be administered before the trip. No medications will be accepted outside of normal school hours. No medications can be accepted without the required paperwork.

·  A Parent Provider Authorization (PPA) form must be signed by the medical provider and submitted, along with the medication, to the school nurse. A separate form is required for each medication.

·  A Bilateral Release of Information form must be submitted.

·  No more than a 30-day supply of medication can be accepted.

·  Prescription medication must be delivered in the original medication bottle with the pharmacy label intact.

·  Over-the-counter medication (OTC), if required by a medical provider for a chronic or emergency condition, must be delivered in the original, unopened, and sealed medication bottle with the manufacture’s label intact and the child’s name on the bottle.

·  Students are not allowed to carry any medication with them on the trip.

Please, sign and return the attached page to the school nurse or Mr. Wine. Contact your child’s school nurse if you have any questions.

Thank you,

Stacy Knowlton, RN

AJHS School Nurse

887-1960

In reference to the up-coming Band trip May 5-7th to Orlando concerning medication for an overnight fieldtrip. Please turn this form into the AJHS school nurse or Mr. Wine.

I______, the parent of______have received and understand the overnight fieldtrip guidelines of Auburn City Schools.

______

Parent/Legal Guardian Signature Date

855 East Samford Avenue · P.O. Box 3270 · Auburn, Alabama · 36831-3270

(334) 887-2100 · Fax (334) 887-2107