About this Form
Form number: 525-13
Audience: Attending Physician, Parents/Guardians
Last revised: February 2017
Form 525-12 - Authorization to Provide Medically Prescribed Treatment
Form 525-14 - Emergency Care for the Management of a Student With a Diagnosis of Anaphylaxis
INFORMATION: The Montgomery County Department of Health and Human Services and 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.
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