School Nurse Medication Authorization Form

This printable Medication Authorization Form helps school nurses and school health offices document medication permissions and provider instructions for medications given during the school day.

The form provides clear medication authorization and administration orders from a healthcare provider along with documented parent or guardian consent, helping ensure medications are administered safely and appropriately in the school setting.

Designed with school nurse workflows in mind, this form organizes essential information in one place to support communication between families, healthcare providers, and the school health office.

This form was created with Illinois school health practices in mind and includes sections commonly required for medication administration documentation.

Ideal For:

• School nurses

• Health office documentation

• Medication administration authorization

• School health records

• Beginning-of-year paperwork

Disclaimer:

This resource is intended for organizational and educational purposes only. While this form was designed with Illinois school medication administration practices in mind, school nurses and administrators should review and modify the form as necessary to ensure compliance with their local school district policies, Illinois state regulations, and healthcare guidelines.

The creator of this resource assumes no responsibility for misuse of this form or failure to comply with applicable laws or district policies. Always follow your school district’s approved medication administration procedures.