Medication Forms

Notice to Parents Regarding Medication Administration at School

Parents should always attempt to arrange their student’s medication to be taken outside of school hours. If a student must take medication during school hours, the following guidelines must be met. Per WI Law-Stat 118.29: An Authorization for Administration of any medication (prescription and OTC), by school staff, must be completed before the medication can be administered in school. All medications must be in their original containers.

Allergy Action Plan
To be completed at the start of every school year for students with life-threatening allergies.

Asthma Action Plan
To be completed at the start of every school year for students with asthma.

Diabetes Emergency Action Plan
To be completed at the start of every school year for students with Diabetes.

Medication Information for Parents
Please read the district guidelines and state laws regarding medication administration during school hours.

Permission for Over-the-Counter Medication
To be completed at the start of every school year for all over-the-counter medications that need to be given to your student during school hours.

Permission for Prescription Medication
To be completed at the start of every school year for all prescription medications that need to be given to your student during school hours.

Permission to Self-Carry Medication

FOR HIGH SCHOOL ONLY: To self-carry prescription medication, school nurse must approve.  Only parent approval needed for over the counter medication. Permission must be renewed every school year.  Must also have either "Permission for Over-the-Counter Medication" form and/or "Permission for Prescription Medication" form completed and on file with the office. 

For JK-8th grade: School nurse and principal must approve any self-carrying of medication.  Please contact your school's nurse for further information

Contact Information

Katelyn Lasse

Katelyn Lasse, BSN, RN, NCSN

District Nurse
(414) 773-1961
Email