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Authorization to Administer Prescribed Medication
Release and Indemnification Agreement

The Montgomery County Department of Health and Human Services and the Montgomery County Public Schools discourage the administration of medication to students in school during the school day. Any necessary medication that possibly can be administered before and after school should be so prescribed. Only non-parenteral medications are administered except in specific emergency situations. School personnel will, when it is absolutely necessary, administer medication to students during the school day and while participating in outdoor education programs and overnight field trips, according to the procedures outlined on the back of this form.

  • This form is for: Parents/Guardians, Physicians
  • Form number: 525-13
  • Last revised: January 2013
Name
PDF Size
Form Number
Authorization to Administer Prescribed Medication
Release and Indemnification Agreement
78 K 525-13

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For questions regarding forms, call Harriet Potosky at (301) 279-3538.

Updated February 6, 2013 | Maintained by Missy Gumula
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