Parental Consent for the Administration of Paracetamol in School

IMPORTANT INFORMATION FOR PARENTS

This form must be completed by a person who legally holds parental responsibility.

By completing this form, you are consenting to the administration of non-prescribed paracetamol for the relief of pain and/or fever relief by our School Nurse.

A separate form for the administration of prescribed medicines is available HERE.
* To read our policy on the Administration of Medicines in school CLICK HERE.

If you wish to withdraw your consent at any time, please email Miss James - School Nurse: kjames@tggsacademy.org

Student's Surname *

Student's Forename(s) *

Date of Birth: *

Day

Month

Year

Does this student have any known allergies to any medicines? *

Yes

No

Please give details, eg. name of drug(s), reaction experienced:

Declaration

Paracetamol must only be administered to students by the School Nurse.
The school will not accept liability where paracetamol is carried or self-administered by any student under the age of 16.

I authorise the School Nurse to administer paracetamol to my child, as and when required, for pain and/or fever relief in school. *

Please confirm your understanding and agreement to the above Declaration

My child usually takes the following dose of paracetamol:

Parent/Carer Name *

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Parental Consent for the Administration of Paracetamol in School