NON-PRESCRIPTION MEDICATION PERMISSION FORM

I give permission for ArtsWest School to administer non-prescription medication to my child,
I have provided the following for the school to have on hand for my child:
□ Tylenol/Acetaminophen
□ Advil/Ibuprofen
□ Cough Drops
□ Other

I would like to be contacted before medication is given out: □ yes □ no
(Parent/Guardian Signature)