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Request to Carry Medication
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Request to Carry Medication
Handle: Document-4684
Owner: Site Administrator (User-2, admin:DocuShare)DS
Wednesday, June 9, 2010 09:42:31 AM CDT
Wednesday, June 9, 2010 09:42:31 AM CDT
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  • Haysville USD 261 1745 West Grand Haysville, KS 67060 (316) 554-2200 Fax (316) 554-2230 Date Name: Address: City, State, and Zip: This letter is intended to clarify your appeal of an official Board of Education policy as per allowing a student to keep on their person prescription medication.
  • The Board has made an exception to their policy in the case of ______________________ and your parental request to allow him/her to carry a prescription.
  • ___________________________________ ___________________________ Signature of Physician Date I herby give my permission for __________________________________to take the aforementioned prescription at school.
  • _________________________________ ...
Microsoft Office Word (.doc, .dot) - application/msword
Appears In: Health Services
Preferred Version: Request to Carry Medication