Permission to Administer Medication on Parent/Carer’s Behalf

In order for school staff to administer medicine on a parent/carer’s behalf we must have signed permission beforehand.
Please complete this form which will be sent to the School Office.

I give my permission for a member of school staff (teaching or support staff) to administer the above medication to my child.
Please write your name in the text box below to confirm you are giving your permission:

Address

Orleans Primary School, Hartington Road, Twickenham, Middlesex, TW1 3EN