Required for all prescription and over-the-counter medications administered at school. Must have physician and parent signature.

 

Good for (3) days only, does not require a physician's signature to administer. Please read form carefully prior to sending in with your student.

 

 

Permission for student to Self-Carry Asthma Inhaler/Other Emergency Medications 

 

 

Ohio Immunization Exemption Form  

For student who do not meet the state-required minimum for immunizations due to health/medical, religious, or philosophical reasons. Complete and return to your student's school. Immunization exemptions do not need to be completed every year. Please contact the clinic with any questions and/or concerns regarding this.