Medication Forms

Plymouth-Canton Community Schools’ policy and the State of Michigan law prohibits school employees from dispensing medication of any kind to students without written permission from the student’s physician and parent. If it is essential that medication be administered at school, the following are necessary.

Parents must bring all medications to the school office. Medication MAY NOT be hand carried to school by students unless self administration forms are on file.

1. Medications (with the exception of controlled substances) may be carried by students under special circumstances.  A different medication permission form is needed to self-carry these medications.  The Authorization for SELF-ADMINISTERED MEDICINE form is available through the school office or at the link below.

   • Authorization for Self-Administered Medicine form (PDF)

    This form is REQUIRED FOR ALL MEDICATIONS, including over the counter items such as aspirin, cold remedies, cough medicines, cough drops, eye drops, ointments, etc.  No medication of any kind is to be sent to school to be taken independently by the student without the necessary paperwork on file. It is the responsibility of the parent to secure the information from the physician along with the required signature.  Please contact the school office or school nurse if you have further questions about the parameters surrounding medications.  

2. Medication must be in the ORIGINAL CONTAINER FROM THE PHARMACY clearly marked with the student’s name, medication, dosage, expiration date and time to be given.
3. For medication to be given during school hours by SCHOOL STAFF: written permission from the student’s parent or guardian and their physician must be on file in the school office before any medication can be given.  This must include – student’s name, medication, dose, time to be given, and physician’s signature.  The Physician & Parent Medication Authorization form can be found at the link below or a copy can be obtained from the school office.

• Physician & Parent Medication Authorization Form (PDF)

P-CCS Bylaws & Policies - Use of Medications Policy  search for the complete term: '5330 - Use of Medications'