Medical Administration Forms

Guidelines For The Provision Of Medications/Section 504 Accommodations
For Students In New York City Public Schools – School Year 2016-2017

Medications Administration Form/MAF: The physician/health care provider completing the form should be the one who will actively manage the condition for which services are requested.

The MAF must be completed by your health care provider and the back of form signed by the Parent.

Students with a Chronic Diagnosis, who need to take medications in school, must have a completed MAF each school calendar year.

Medications prescribed must be labeled by the pharmacy as prescribed by your medical provider. The completed form with the medication prescribed, must be given to the School Nurse, on return to school.

Please attach a small current photograph of your child to the upper left corner of the Medication Administration Form (MAF) for proper identification.

All Medications including “over the counter medications,” requires a completed MAF.

For cases of Asthma, medical providers may attach an Asthma Action Plan with the MAF. Please contact the student’s school if you have any questions.

Below, please find links to the Medical Administration Forms:

MAF_Generic_2016-17

MAF_Allergy Anaphylaxis 2016-17

MAF_Asthma 2016-17

Thank you for your assistance.

 

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