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Student Questionnaire
Media Release Form
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Emergency Record Form
Anaphylactic Allergy Plan
Child’s Medical Needs Form
Support Plan (ISP) for Special Needs
Authorization OTC Skin Products
Authorization for Prescription Medication
Contact
2965 Hwy 43, Kemptville
+1-613 258-1931
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Home
Our School
About Montessori
Programs
Infant Program
Toddler Program
Casa Program
Kindergarten Program
Before & After Care Program
Forms
COVID Response Plan
Admission Form
Student Questionnaire
Media Release Form
Bag Lunch Policy
Tuition Fees
Emergency Record Form
Anaphylactic Allergy Plan
Child’s Medical Needs Form
Support Plan (ISP) for Special Needs
Authorization OTC Skin Products
Authorization for Prescription Medication
Contact
AUTHORIZATION FOR ADMINISTERING PRESCRIPTION MEDICATION
PLEASE READ AND FILL OUT THE FORM BELOW
Phone
I herby authorize Madison Montessori Academy to administer the following medication to my child
Prescription
*
Dosage
*
Date(s) in which medication is to be given:
Reason for medication:
Time(s) in which medication is to be given:
Storage Instructions:
Potential Side Affects:
Signature of Parent
Date
