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PARENTAL AGREEMENT FOR SCHOOL TO ADMINISTER MEDICINE

The school will not give your child medicine unless you complete and sign this form. The school has a policy that staff can administer medicine.

|Child’s Name | |

| | |

|Child’s Class | |

| | |

|Name and strength of medicine | |

| | |

|Expiry date | |

| | |

|How much to give (ie dose to be given) | |

| | |

|When to be given | |

| | |

|Length of time to be given | |

| | |

|Number of tablets/quantity to be given | |

|to school | |

| | |

|Any other instructions | |

| | |

|Note: Medicines must be in the ORIGINAL container as dispensed by the pharmacy |

| | |

|Daytime contact number of parent/carer | |

| | |

|Name and phone number of GP | |

| | |

| | |

|Agreed review date to be initiated by | |

|(name of staff member) | |

The above information is, to the best of my knowledge, accurate at the time of writing and I give consent to school staff administering medicine in accordance with the school policy. I will inform the school immediately, in writing, if there is any change in dosage or frequency of the medication or if the medicine is stopped.

Parent’s/Carer’s Name (please print):

Parent’s/Carer’s Signature:

Date:

St Joseph’s Cathedral Primary School is the data controller for the personal information you provide on this form. Your information will be used to ensure your child’s health and medical needs are met whilst in our care. We will not share your data with any third parties without your explicit consent unless we are required or permitted to do so by law.

Data protection law describes the legal basis for our processing your data as one based on legal obligation as we are required to understand the medical or other needs of our pupils in order to keep them safe from harm. For further information about how the school uses your personal data, including the rights of a data subject, please see our school privacy notice on our website

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ST JOSEPH’S CATHEDRAL PRIMARY SCHOOL

Following Jesus As We Live And Learn Together

Headteacher: Mrs Angela Heald

web: stjosephscathedralprimary.swansea.sch.uk

email: stjosephscathedralprimary@swansea-.uk

post: Caepistyll Street, Greenhill, Swansea SA1 2BE

phone: 01792 653609

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