Forms → Parents & Students → Health → Authorization to Provide Medically Prescribed Treatment
Form number: 525-12
Audience: Parents/Guardians, Attending Physician
Last revised: February 2019
Form 525-13 - Authorization to Administer Prescribed Medication
Form 525-14 - Emergency Care for the Management of a Student With a Diagnosis of Anaphylaxis
INSTRUCTIONS/INFORMATION: “Medically prescribed treatment” does not mean “medical services” as defined in the regulations of the Individuals with Disabilities Education Act, 34 C.F.R. Section 300.13, and/or the Code of Maryland Regulations, 13A.05.01.02. This form is to be used in consultation with the School Community Health Nurse (SCHN) for treatments such as: urinary catheterization, tracheostomy, gastrostomy feedings, and oral suctioning. These are only illustrations of typical treatments and not an all inclusive listing. Consult with SCHN for further information.
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