Name of pupil Date medicine provided by parent Group/class/form Quantity received Name and strength of medicine Expiry date Quantity returned Dose and frequency of medicine Staff signature Signature of parent *For all medication it is essential that the dose is written clearly with the units for example – 2 x 5 mg. Fridges: If any medication is stored in fridges, ensure that routine temperature monitoring takes place. In most schools a small separate fridge is most appropriate Date Time given Dose given * Name of member of staff Staff initials Date Time given Dose given* Name of member of staff Staff initials Date Time given Dose given* Name of member of staff Staff initials Date Time given
Name of pupil Date medicine provided by parent Group/class/form Quantity received Name and strength of medicine Expiry date Quantity returned Dose and frequency of medicine Staff signature Signature of parent *For all medication it is essential that the dose is written clearly with the units for example – 2 x 5 mg. Fridges: If any medication is stored in fridges, ensure that routine temperature monitoring takes place. In most schools a small separate fridge is most appropriate Date Time given Dose given * Name of member of staff Staff initials Date Time given Dose given* Name of member of staff Staff initials Date Time given Dose given* Name of member of staff Staff initials Date Time given
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