Medications at School

Medication cannot be administered to any student without appropriate authorization forms completed and on file. Any medication must be provided in a new, sealed container with the completed authorization form. Students may NOT transport medication to and from school. Any medication not meeting the PWCS regulations will not be administered to your student.

In accordance with the Code of Virginia 22.1-274.2 and § 8.01-226.5:1, students diagnosed with asthma or anaphylactic reaction may possess and self administer certain inhaled asthma medications, self-injected epinephrine, or other emergency medication, with the appropriate authorization form on file.

Medical Authorization Forms

• Authorization for Medication Administration (PDF)
• Authorization to Implement Health Treatment Plan (PDF)
• AUTORIZACIÓN PARA ADMINISTRACIÓN MÉDICA - Español (PDF)
• Seizure Action Plan (PDF)
• Asthma Action Plan (PDF)

Management of Allergic Reactions in the School Setting

(Food Allergy and Anaphylaxis Emergency Care Plans must be submitted annually at the beginning of each school/SACC year dated after May 1, and whenever modifications are made to this plan.)

• Food Allergy & Anaphylaxis Emergency Care Plan (PDF)
• Request for Administration of Medication for Allergic Reactions (PDF)
• Permission for Student to Carry and/or Self-Administer Epinephrine (PDF)
• Severe Allergy Individual Health Care Plan (PDF)
• Student Allergy History Form (PDF)

Management of Diabetes in the School Setting

• Virginia Diabetes Medical Management Plan (DMMP)(PDF)
• Diabetes Treatment Log (PDF)

Other Medical Forms

Medication Permission Form for Extended Day/Overnight Field Trips (PDF)

The following health forms are required for enrolling a student in Prince William County Public Schools.

• Instructions
• Commonwealth of Virginia School Entrance Health Form
  • School Health Entrance Form Instructions
  • Commonwealth of Virginia School Entrance Health Online Fillable Form
  • Commonwealth of Virginia School Entrance Health Form - Spanish (Mancomunidad de Virginia Formulario de Salud Para El Ingreso Escolar)
• Tuberculosis (TB) Screening Requirements (English)- R723.4 (Refer to regulation regarding form needed. Attachments I-IV included below.)
  • Tuberculosis Screening Student Enrollment Form (PDF)
  • High TB Burden Country List 2018 (PDF)
  • Report of Tuberculosis Screening (PDF)
  • Report of Tuberculosis (TB) Screening and Clearance (PDF)

Health Regulations

• Immunization Requirements 723-6
• Facts About Head Lice - 753-2 Attachment I
• Head Lice Prevention and Treatment - Reg 753-2 Attachment II
• Management of Allergic Reactions in the School Setting - Reg 757-2
• Management of Asthma in the School Setting - Reg 757-5
• Management of Diabetes in the School Setting - Reg 757-6
• Management of Epileptic Seizures in the School Setting - Reg 757-7
• Management of Medication Administration in the School Setting Reg 757-4
• Management of Students with Health Treatment Plans - Reg 757-3
• Management of Head Lice in the School Setting - Reg 753-2
• Physical Examinations 723-5
• Physical Screenings and Testing - Reg 756-1

Fact Sheets and Other Resources

• Management of Life-Threatening Allergies in Schools and School Age Child Care (PDF)
• Allergy Guidelines (Letter) (PDF)
• Vision and Screening, Scoliosis Fact Sheet (PDF)