ࡱ> EGDc Xbjbj 4&؎U\؎U\H  (((((<<<8t4$<'('''''''$*-'('(('F((''$~&h;R%''0'(%_.U4_.,~&_.(~&''|'(_. > :  School District Letterhead Sample End of Year Medication Pick-Up Information Dear Parent/Guardian: Date: ___________ Student Name ____________________________ Teacher _________________ Grade _________ The end of the school year is quickly approaching! All unused medications must be picked up by the end of the school year. Unless your child has current permission to self-carry their medication, the school cannot allow your child to bring the medication home themselves. If you need to make special arrangements to pick up medication, please call to make arrangements. Medications not picked up, will be discarded on ____________. Important Information to keep in mind for next school year: New medication forms for both prescription and over-the-counter (OTC) medications must be signed every year by a health care provider and parent/guardian. Medication must remain in the properly labeled pharmacy or original OTC container. The parent/guardian is responsible to have the medication delivered directly to the school in a properly labeled original container by an adult. If you child has rescue medications for respiratory conditions, epinephrine auto-injector, or insulin, glucagon, and related diabetes supplies, there must be a provider written permission which includes an attestation that the student has demonstrated the ability to self-administer and written parent/guardian consent. For other conditions, your child may be able to self-carry and self-administer, but will need written permission from both you and your provider. We request that you ask your pharmacist to give you a second identically labeled container for any prescription medications your student will take at school. We also request that you bring small containers of any OTC medications that your child will take. This will allow the School Nurse to send these medications on field trips and comply with New York State laws pertaining to medication storage. Medication forms are available on the district web site or may be obtained from the school health office. Your healthcare provider may use their own form if desired. Thank you in advance for your cooperation, School Nurse:School:Phone #:Fax:Email: This sample resource is located at  HYPERLINK "http://www.schoolhealthny.com " www.schoolhealthny.com  Forms | Notifications 3/2017     #$0OPyتk\J<+ h}}h}}CJOJQJ^JaJh}}CJOJQJ^JaJ#h}}hyip5CJOJQJ^JaJhA 5CJOJQJ^JaJ,h}}h'5B*CJOJQJ^JaJph&hH5B*CJOJQJ^JaJph&h'5B*CJOJQJ^JaJph,h}}hyip5B*CJOJQJ^JaJph,h}}h}}5B*CJOJQJ^JaJph,h}}h\n5B*CJOJQJ^JaJph h}}hyipCJOJQJ^JaJ $OP j Q $]dd-DM [$\$gdyip & F gd3p & F gdyip & F gd#gdgdbgd}}$a$gdHgdyip$a$gdyip]gdyipyz}  Z 2 Q n u  ᰛxxexUUxB$h}}hCJOJPJQJ^JaJhbCJOJPJQJ^JaJ$h}}h\nCJOJPJQJ^JaJ$h}}hZTeCJOJPJQJ^JaJh*fCJOJPJQJ^JaJ)h}}hB*CJOJQJ^JaJph)h}}hyipB*CJOJQJ^JaJphhbCJOJQJ^JaJh}}CJOJQJ^JaJ h}}h}}CJOJQJ^JaJhKtCJOJQJ^JaJ 0 ; > L h i j t u Ůu`KKK9#hyipB*CJOJQJ^JaJph)h}}hyipB*CJOJQJ^JaJph)h#hyipB*CJOJQJ^JaJph#hbB*CJOJQJ^JaJph#h*fB*CJOJQJ^JaJph)h}}h\nB*CJOJQJ^JaJph,h}}hyip5B*CJOJQJ^JaJph&h*f5B*CJOJQJ^JaJph&hH5B*CJOJQJ^JaJph#hqB*CJOJQJ^JaJph O P Q b A l #Zɷ{iRi@i{#h.B*CJOJQJ^JaJph,h`h`5B*CJOJQJ^JaJph#h`B*CJOJQJ^JaJph)h}}hyipB*CJOJQJ^JaJph#hbB*CJOJQJ^JaJph)h3ph3pB*CJOJQJ^JaJph#h3pB*CJOJQJ^JaJph)hk BhyipB*CJOJQJ^JaJph$hk BhyipCJOJPJQJ^JaJhk Bh#CJOJQJaJZ~ 7\]ԭweP8/h th}}CJOJPJQJ^JaJmHnHu)h}}h}}B*CJOJQJ^JaJph#hyipB*CJOJQJ^JaJphhCCJOJPJQJ^JaJ$h}}h2CJOJPJQJ^JaJ$h}}hyipCJOJPJQJ^JaJ)h}}hB*CJOJQJ^JaJph#hCB*CJOJQJ^JaJph)h}}hyipB*CJOJQJ^JaJph,h}}hyip5B*CJOJQJ^JaJph]Rkd$$Ifl\T4'A  tr'644 lap(yt t $Ifgd tdd-DM [$\$gd )*0123GHIKLNOQRTUVWX;vvg_[_[_[_[VR[ghF hF6hljhlUh+hXCJOJQJ^JhqCJOJQJ^J hu>hb0JCJOJQJ^JhbhbCJOJQJ^JhbCJOJQJ^JjhbCJOJQJU^Jh+h}}CJOJQJ^Jh}}CJOJPJQJ^JaJ/h th}}CJOJPJQJ^JaJmHnHuh th}}CJaJ6kd$$IflֈT4'vN  tr'644 lap<yt t $Ifgd tHJKMNPQSTUVWX$a$ $]a$gd}} $]a$gd}}2:pyip/ =!"#$% $$If!vh#v#vA #v#v:V l tr'655A 55/ / p(yt t$$If!vh#v#v#vv#v#v#vN :V l tr'6555v555N / / / / p<yt t s2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ OJPJQJ_HmH nH sH tH D`D NormalCJOJQJ_HmH sH tH >>  Heading 1$@& 56CJ>>  Heading 2$$@&a$6DA D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List 44 Header  !4 @4 Footer  !@Y@  Document Map-D OJQJH"H #+w Balloon TextCJOJQJ^JaJ~3~ }} Table Grid7:V0CJOJPJQJaJ6U`A6 }} Hyperlink >*B*phB' QB *fComment ReferenceCJaJ8b8 *f Comment TextCJB/qB *fComment Text CharOJQJ@jab@ *fComment Subject5\N/N *fComment Subject Char5OJQJ\PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. 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