Mason Consolidated Schools
Administrative Guidelines


The medications and/or treatments which may be administered are defined in Policy 5330. In those circumstances where a student must take prescribed medication during the school day, the following guidelines are to be observed:

 A.Parents should determine with their physician's counsel whether the medication schedule can be adjusted to avoid administering medication during school hours.

 B.The Medication Request and Authorization Form 5330 F1 must be filed with the respective building principal before the student will be allowed to begin taking any medication during school hours. This written and signed request form is to be submitted on an annual basis and will include:

  1.student's name;

  2.medication and dosage or procedure required;

  3.times required;

  4.special instructions including storage and sterility requirements; prescribed medication will be started; prescribed medication will no longer be needed;

  7.physician's name, address, and telephone number;

  8.probable side effects;

  9.authorization by both the physician and the parent for a student to self-administer the medication but only in the presence of one (1) authorized staff member;

  10.authorization for school personnel to administer the prescribed medication, if necessary;

  11.agreement/satisfactory arrangement to deliver medication to/from school;

  12.agreement to notify the school in writing if the medication, dosage, schedule, or procedure is changed or eliminated. A new request form must be submitted each school year or for each new medication.

 C.Form 5330 F1c Ė Authorization for the Possession and Use of Asthma Inhalers shall be completed and signed by a physician and the parents authorizing the student use of a metered dose or dry powdered inhaler at school, on District transportation and school activities. This form must be received by the building principal and/or school nurse if one is assigned to the building. Notice of this authorization shall be delivered to the staff members and transportation personnel to whom the student is assigned.
  Students may possess and self-administer a metered dose or dry powder inhaler for relief of asthma, or before exercise to prevent onset of asthma symptoms, while at school, on school-sponsored transportation, or at any school-sponsored activity in accord with the Superintendentís guidelines, if the following conditions are met:

  1.There is written approval from the studentís physician or other health care provider and the studentís parent/guardian to possess and use the inhaler



  2.the building administrator has received a copy of the written approvals from the physician and the parent/guardian.

 D.All medications to be administered during school hours must be registered with the principal's office. Upon receipt of the medication, the principal shall verify the amount of medication brought to the school and indicate that amount on the student medication log sheet.

 E.Medication that is brought to the office will be properly secured. Medication may be conveyed to school directly by the parent or student. Two (2) to four (4) weeks supply of medication is recommended. Medication MAY NOT be sent to school in the student's lunch box, pocket, or other means on or about his/her person. Exceptions to this would be prescriptions for emergency medications for allergies and/or reactions, or inhalers for asthma with proper authorization.

 F.For each prescribed medication, the container shall have a pharmacist's label with the following information:

  1.student's name

  2.physician's name name and telephone of medication

  6.prescribed dosage and frequency

  7.special handling and storage directions

 G.Any unused medication unclaimed by the parent will be destroyed by administrative personnel when a prescription is no longer to be administered or at the end of a school year.

 H.The staff member administering the medication shall ensure that the student takes the medication properly.

 I.If a student does not take the medication at the proper time, the staff member responsible for administering the medication shall take appropriate steps to locate the student and administer the medication and to then notify the parents of the importance of the child reporting on time for his/her medication.

 J.All medications are to be administered in such a way as to not unduly embarrass the student.

 K.A log for each prescribed medication shall be maintained which will note the personnel giving the medication, the date, and the time of day. This log will be maintained along with the physician's written request and the parent's written release.

 L.Form 5330 F1 shall be completed and signed by the principal authorizing the person(s) who may administer the medication or procedure. A second adult must be present during the administration of any medication. A licensed registered professional nurse may administer medication without a second adult present.

 M.If, for supportable reasons, the principal wishes to discontinue the privilege of a student self-administering a medication, s/he shall notify the parent of this decision in sufficient time for an alternative administration to be established. If the student has a disability, the principal shall act in accordance with the regulations covering IDEA or Section 504, if applicable under the circumstances.

 N.Nonprescribed (Over-the Counter) Medications
  A student in grades 9 - 12 may be allowed to possess and self-administer an over-the-counter medication upon the written authorization of the parent. The parent must complete Form 5330 F1a - Authorization for Nonprescribed Medication and Treatment and submit it to the school office for filing in the student's records.
  If a student is found with a medication in his/her possession, his/her record should be checked to determine if the proper authorization is on file. If not, the matter is to be reported to the principal for disciplinary action. The principal may use one or more of the following procedures, depending on the particular situation:

  1.Contact the parent and arrange for the parent to submit Form 5330 F1a as soon as possible.

  2.Take the medication from the student and keep it in the school office until the completed form has been submitted.

  3.Place the student in In-School Restriction for failure to abide by school rules.

  4.Suspend the student from school for no more than ten (10) days.


The purpose of any disciplinary action on this matter should be to make it clear to all students and parents that, because of its policy on drug use, the school cannot allow possession or use of any form of unauthorized drug or medication at any time.

 O.Dispensing of nonauthorized, over-the-counter (OTC) medication by District employees to students served by the District is prohibited. Where investigation confirms such allegations, prompt corrective action shall be taken up to and including dismissal.

 P.In order to minimize health and safety risks to student-athletes and maintain ethical standards, school personnel, coaches, athletic trainers, and lay coaches should never dispense, supply, recommend, or permit the use of any drug, medication, or food supplement solely for performance-enhancing purposes.

Revised 1/98
Revised 6/00
Revised 11/20/00