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A Primary Trust for Primary Schools

Lumen Learning Trust

Riverbridge Primary School

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    Riverbridge Pupil Medication Request

    Where possible the need for medicines to be administered at school should be avoided. Parents are therefore requested to try to arrange the timing of doses to avoid lesson time and the subsequent impact on your child's learning.
    We will administer medicines to your child as close as possible to the requested time.

    Once submitted, a copy of this form will be sent to your supplied email address for your records.

    Please tick the box if you agree to:*
    Please tick the box if you agree to:*
     Name of medicineDosageTime of day requiredCompletion date of course
    Medicine 1
    Medicine 2
    Medicine 3
    Medicine 4

    Please type the letters and numbers displayed in the image into the textbox below to verify you wish to send this response. If you have difficulties reading the letters in the image below you can try a different image by clicking on it.

    Verification Image