If your child has a chronic health condition such as asthma, diabetes, a seizure disorder, or a
food allergy requiring an epi-pen the school division requires that the school clinic have a Health
Care Action plan that is signed by a physician and parent. The Action plan can also include
permission for medication.
See attached links for Health care plans that can also be found on the LCS website.
Allergy Action plan
Asthma Action plan
Virginia Diabetes Medical Management Plan (DMMP)
Seizure Action plan
If your child does not have one of the above chronic illnesses but requires medication while at
school the clinic must have a Physician/Parent Authorization to Administer Medication form.
This form must be completed and signed by both the parent/guardian AND the physician. While
we highly encourage parents to make every attempt to give their student’s medications at home,
we understand that there are circumstances that will require your student to take their meds at
school. Please consider the following guidelines for medication administration by the
nurse/clinic while your student is in school:
●A parent always has the right to come to the school and administer medication to their student at
any time during school hours. .
●A Physician/Parent Authorization to Administer Medication form must be completed, signed
and dated by both the prescribing physician and the parent. A parent/guardian should turn
in this form with the medication to be given at school.
●No medication (including over the counter medications like Tylenol and Advil) will be given
without a signed authorization form that is complete.
●All medications must be brought to the school by the parent/guardian. Medication must be
signed in by both the parent and the nurse/school designee. Please allow 15 minutes in order to
accomplish this when you come to the school. Medications may not be brought to school by the
student. Prescription medications must be in the original pharmacy bottle containing the
student’s name, medication name, dosage, route, and frequency.
●Over the counter medication must be in a sealed, original container. The nurse can not
accept any opened containers.
●Students are to report to the clinic at the time their medication is to be administered.
●The parent/guardian must bring in more medication when it is needed.
●It is the parent’s responsibility to pick up medication at the end of the year. No
medication will be kept over the summer or until the next school term.
Jill Wood, RN
School Nurse
E.C. Glass High School
2111 Memorial Avenue
Lynchburg, VA 24501
(434)515-5370
woodjw@lcsedu.net
