Parents and Guardians,
Please click here to go to our website for The NCLA Student Medication Authorization Forms.
For Parent's/Guardian's of a student that require self-administration of an inhaler or Epi-Pen, please sign and return the Self-Administration Form along with the above form.
The NCLA Student Medication Authorization Form is required for any student that will need medication dispensed during school hours and/or school functions. The form must be completed and signed by a parent/guardian, as well as a physician for any over the counter or prescribed medication.
Please bring the completed form(s), along with the medication to the front office. Any prescribed medication must be in it's original prescription bottle.
If you currently have medication for your student in the office, from this previous school year, two steps must be taken.
1. Complete a new Student Medication Authorization Form
2. Come into the office to verify that the medication has not expired
If you have any questions please contact the school office.
Respectfully,
Katie Lohr
Office Manager
The North Carolina Leadership Academy
4353 High Point Rd
Kernersville, NC 27284
(O)336-992-2710
(F)336-769-2254
