Medical Forms

Students may have prescription or over-the-counter medication at school for regular or occasional use.  In such cases the parent or guardian is required to fill out a Medication Consent Form to give signed permission listing dosage and directions.  All medication and medical items will be kept in the school office, or, in special circumstances, with a designated teacher.  Cough drops are not considered medication, but must be turned over to the teacher to dispense as needed.  Certain students requiring inhalers or other rescue medication may carry their own device with doctor’s written direction and release form, which is kept on file.


Non-prescribed medication may only be dispensed to students who have a parent/guardian permission slip on file and who have delivered the medication in a pharmacy-labeled container to the school office. St. Rita School does not provide any over-the-counter medications to students including pain relievers, fever reducers, or cough drops.  

ArchdioceseInhalerForm (pdf)

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NonPrescriptionMed_Form5140 (pdf)

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PhysicianMedicationForm (pdf)

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PrescriptionMedForm5140 (pdf)

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