Parent Consent Form for Medication: 2025-2026

It is our policy to have written permission from the parent before medication is distributed to your child.

Your child's medicine must be in the correct bottle with correct instructions. If the medication is decreased, increased, or changed, during the school year, a new written permission will be required to provide us with proper instructions.

A doctor's prescription is MANDATORY for all prescribed and over the counter medications, to be administered to the children. Please DO NOT send medication without a doctor's prescription. Thank you for your cooperation.

Parent Name Parent Name Title First Last Suffix
Email
Child's Name Child's Name First Last
Medication Name
Medication Dosage
Medication Route

Medication Route By Mouth (Swallowed/Chewable Pills, or Liquid) Topically (Any Creams) Injections (any shots - ex. Insulin, Epi, or Glucagon) Eye Drops Inhalation Nasal Spray
Time Medication Should be Dispensed

Time Medication Should be Dispensed Before Lunch After Lunch PRN / As Needed
If medication is to be taken PRN (as needed), how often can the medication be dispensed?

If medication is to be taken PRN (as needed), how often can the medication be dispensed? Every 2 hours Every 4 hours Every 6 hours Every 8 hours Every 12 hours
Reason for Medication
Corpus Christi Catholic School
6300 McKenna Drive
Mobile, AL 36608
Telephone: 251-342-5474
Email: school@ccscatholic.com
Nurse Kachel: jkachel@ccscatholic.com
Website: school.corpuschristiparish.com

SCHOOL YEAR: 2025-2026

It is our policy to have written permission from the parent before medication is distributed to your child.

Your child's medicine must be in the correct bottle with correct instructions. If the medication is decreased, increased, or changed, during the school year, a new written permission will be required to provide us with proper instructions.

A doctor's prescription is MANDATORY for all prescribed and over the counter medications, to be administered to the children. Please DO NOT send medication without a doctor's prescription. Thank you for your cooperation.

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