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Dispensing Medication Forms
A note regarding dispensing medication at school.  The Non-Prescription medication form requires a parent signature, while the Prescription Medicaiton form requires parent and physician signatures. If you have any questions regarding these forms, please reach out to one of our school nurses for assistance:

Jennifer Pike
School Nurse
Fairfield Union High School & Bremen Elementary

Janeen Thompson
School Nurse
Rushville Middle School & Pleasantville Elementary
email:
  
[email protected]
Attachments Available To Download:
Non-Prescription Medication Request Form (Dispensing Medication at School)
Non-Prescription Medication Request Form (Dispensing Medication at School) (RTF)
Prescription Medication Request Form (Dispension Medication at School)
Prescription Medication Request Form (Dispension Medication at School) (RTF)