Parents
Health

Medication Authorization

Additional Health Forms

Epi-Pen Form
Students with severe allergies who require an Epi-Pen for emergency use at school are required to have an Allergy and Anaphylaxis Action Plan in place with the school. The Colorado Allergy and Anaphylaxis Emergency Care Plan and Medication Orders must be completed by your child’s health care provider. Click here for the form.
 
Inhaler Form
If your child has asthma and requires an inhaler at school (no Epi-Pen), the Colorado School Asthma Care Plan must be completed by your child’s health care provider. Click here for the form.

Epi-Pen and Inhaler Form
If your child requires an Epi-Pen and an inhaler at school, the Colorado Allergy and Anaphylaxis Emergency Care Plan and Medication Orders must be completed by your child’s health care provider. Click here for the form.

Student Self-Carry Form
If your child will carry their own inhaler or Epi-Pen, this must be indicated on the action plan and the self-carry form must be filled out, signed and approved. The appropriate contract must be completed by you and your child and provided to the school. Please click here for the Student Carry Inhaler Contract or click here for the Student Carry Epi-Pen Contract.

Medication Administration Form
If your child requires any additional medication at school, a separate medication permission form signed by both parent and health care provider is required. Please remember a separate form is required for each medication. Please click here to download and print the Medication Administration form. Again, please remember that we cannot accept any medication without the required authorization/paperwork. 

Please note: 
  • Phone call authorizations cannot take place of this form.
  • Each medication kept on campus requires a separate completed and signed Medication Authorization Permission form, and the forms must include the exact dosage information.
  • Medications include all vitamins, supplements, cough drops, lactase, OTC medications such as ibuprofen, probiotics ETC.
  • Parents and guardians are welcome at school to administer necessary medications for their students at any time.
Please bring all medications, along with the appropriate completed and signed forms, to the reception desk in the administration building. Medications kept at school must be a current prescription (not expired), in its original packaging, and accompanied by completed Medication Administration Forms.

Medications and forms will be checked in and approved by our Nurse at the beginning of the school year.

Medication on Field Trips
If your child will need to take any type of medication while on a field trip, whether prescription or over-the-counter, you must submit a Medication Administration Permission form completely filled out and signed by a physician. 


Boulder Country Day School    4820 Nautilus Court North • Boulder, Colorado 80301 • Phone - 303.527.4931 • info@bouldercountryday.org
Boulder Country Day School, where academic distinction meets education with character. BCD is a top rated, accredited private school in Boulder, Colorado where every child has the opportunity to discover their own unique excellence. Distinguished by small class sizes, outstanding faculty, engaging academics and a focus on community, our preschool, elementary and IB middle school teachers strive to create a well-rounded educational environment that balances traditional subjects with the arts, world languages, athletics and knowledge based units.

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