What information should be included on a school medication administration form for students with conditions such as Attention Deficit Hyperactivity Disorder (ADHD) treated with Ritalin (methylphenidate) or Adderall (amphetamine and dextroamphetamine), asthma treated with albuterol, or severe allergies requiring an EpiPen (epinephrine)?

School Medication Administration Form: Essential Components

A school medication administration form must include specific, clear, and detailed written instructions on a dated, standardized format that addresses the "rights" of medication administration—covering student identification, medication details, dosage, route, timing, and comprehensive documentation requirements. 1

Core Required Elements

Prescriber and Authorization Information

• Written medication order signed by the authorized prescriber with the student's name, drug name, exact dose, approximate administration time, and diagnosis or reason the medication is needed 1
• Written parental approval/consent for medication administration by school staff or for student self-administration 1
• Date on the form to ensure currency of the order 1
• For over-the-counter medications, written parental approval with limited duration specified 1

Student and Medication Identification

• Student's full name with photo verification capability 1
• Complete medication name (brand and generic) as it appears on the pharmacy prescription label 1
• Current medication allergy list for cross-referencing 1
• Medication expiration date tracking 1

Dosing and Administration Details

• Exact dose using leading zeros before decimals and avoiding trailing zeros after decimals (e.g., 0.5 mg, not .5 mg or 5.0 mg) 1
• Student's weight in kilograms documented clearly for weight-based dosing verification 1
• Specific route of administration: oral, sublingual, gastrostomy/jejunostomy tube, ear, eye, nasal, intramuscular, intravenous, subcutaneous, rectal, inhaled, or topical 1
• Timing specifications: scheduled times with notation that administration may occur 30 minutes before or after scheduled time unless otherwise specified 1

Clinical Monitoring and Safety

• Indication for the medication and expected effectiveness 1
• Known side effects and adverse reactions to monitor 1
• Contraindications and drug interactions review 1
• Student assent or refusal documentation 1

Storage and Accountability

• Storage requirements according to manufacturer's guidance 1
• For controlled substances like methylphenidate (Ritalin) or amphetamine-dextroamphetamine (Adderall): double-lock storage requirement with documentation of administration reviewed regularly 1
• Methylphenidate specifically should be stored at room temperature between 68°F to 77°F (20°C to 25°C), protected from light and moisture, in a locked cabinet 2
• Inventory tracking of medication delivered to school and returned home, signed by school nurse or health team member and parent/guardian 1

Documentation Requirements

• Current at-home and at-school medication list 1
• Real-time medication administration recording at time of delivery 1
• Medication error documentation by licensed personnel and unlicensed assistive personnel (UAP), including missed doses, lost or wasted medication 1
• Procedure for locating students who do not show to health room for scheduled medications, as missed doses constitute medication errors 1

Special Considerations for Common School Medications

ADHD Medications (Ritalin/Adderall)

• These are DEA Schedule II controlled substances requiring heightened security 2
• For children 6 years and older: typically administered 2 times daily before breakfast and lunch, 30-45 minutes before meals 2
• Timing consideration: last dose should be before 6 PM to avoid sleep problems 2
• Missing doses has significant impact on schoolwork and friendships, making adherence tracking critical 3

Emergency Medications (Albuterol, EpiPen)

• Immediate access protocols must be specified, as these are life-saving interventions 1
• Location specifications for storage to maintain both security and timely access 1
• Field trip procedures identifying who carries the medication 1
• Emergency action plans or emergency care plans should accompany the medication form 1
• Schools should maintain adequate supply for lock-down or evacuation scenarios 1

Self-Administration Assessment

• Written recommendation from prescriber regarding student's capacity for self-carrying/self-administration based on appropriate developmental, physical, and intellectual capacity 1
• Competency documentation for student self-administration 1
• Students with more self-responsibility for medications report fewer medication errors 3

Critical Pitfalls to Avoid

Never accept alternative, herbal, or homeopathic medications without written physician order, as these lack FDA safety testing 1

Avoid vague timing instructions—specify exact times or acceptable windows, as missed doses are classified as medication errors 1

Do not permit medication sharing—each medication must be dispensed real-time directly from the student's prescription bottle 1

Ensure UAP supervision—unlicensed assistive personnel who administer medications must be trained, certified, and supervised by a licensed school nurse or physician 1

The form should integrate with individualized health plans (IHP) for students with chronic conditions like asthma, ADHD, or severe allergies, and coordinate with 504 plans or individualized education programs (IEP) when medications are part of disability accommodations 1