Medication Information and Consent Form Name of pupil(Required)Pupil's Date of Birth(Required) DD slash MM slash YYYY House/Form Group(Required)Your Admissions Representative at Buckswood(Required) Russel Noronha (UK Admissions) Cristina Terrazas (International Admissions) Kyoko Field (International Admissions) Sherene Zouehid (International Admissions) Evelina Kalinina (International Admissions) Shun Chi Ngan (Elisa) (International Admissions) Unsure of the representative in charge I consent for my child to receive Over the Counter medication at Buckswood School, as and when required, and emergency medication.This may include pain relief, antihistamines, travel sickness tablets, throat sprays, anti-sickness tablets, hydration tablets, antibiotics, inhalers, etc.Consent(Required) Yes No Other Please list all prescribed and non-prescribed medications, including vitamins/minerals, (daily or emergency medications) that you would like your child to take at Buckswood School. Please include dose, time of medication and route. ALL MEDICATIONS SHOULD BE NEW/UNOPENED.MedicationsSelf administation?(Required) Yes No Do you give consent for the use of generic Ventolin Inhaler/Epipen if required?(Required) Yes No Not applicable For some prescribed medications given from non-UK sources a letter (translated) of confirmation from their health professional is required. Please upload proof or evidence of any prescriptions below.The Buckswood Health Service staff may contact you for further information. If you have any questions please email us: nurses@buckswood.co.ukUpload Prescriptions(Required) Drop files here or Select files Max. file size: 512 MB. Name of parent/carer(Required)Date(Required) DD slash MM slash YYYY Your email address(Required) We require this so we can send you a copy of the information provided.
