Oak Ridge High School Band
Permission to Administer Non-Prescription Medications
___ DO NOT administer any over the counter drugs to my child -___________________________.
___ I hereby give my permission for my child ___________________________ to receive treatment of a non-emergency medical nature. This would include administering medication such as:
|
Medication |
Yes |
NO |
| Acetaminophen (Tylenol) | ||
| Ibuprofen (Advil) | ||
| Benadryl | ||
| Calamine Lotion | ||
| Neosporin or First Aid Creme | ||
| Antacid Tablets/Liquids | ||
| Imodium A/D | ||
| Cold and Sinus Tablets | ||
| Bee/Insect Sting |
Comments: _________________________________________________________
__________________________________________________________________
__________________________________________________________________
___________________________/ _____________
Parent / Guardian Signature Date