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JERICHO

Union Free School District

Medical Accommodation & Medications in School

Medical Accommodation

 

  • This form is to be completed by your child’s healthcare provider to request any specific accommodations that are needed at school due to a medical condition.( for example: need for wheelchair, prolonged gym/recess exemptions, transportation accommodations).
  • Once this form is completed and submitted to your school nurse it will be sent to the district’s school physician for review and needed approval.
  • Please return or e-mail completed form to the school nurse.

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Medical Accommodation

 

Attestation Form

  • At the MS and HS level, if a student is going to self-carry and self-medicate, the Attestation Form must be completed and submitted to the health office. 
  • Please return or E-mail completed form to the school nurse.

 

Medication Authorization Form 

  • A NYS healthcare provider must fill out the Medication Authorization form for all medications to be given in school, including over the counter medications.
  • All medications must be provided in original packaging.
  • All medications including over the counter and prescriptions, must be delivered to the health office by a parent or designated adult.
  • Please return or e-mail completed form to the school nurse.