Page 58 - McDowell Full Digital Handbook 2017-18

Adopted 8/1/09
Revised 6/13/11
Revised 7/28/14

© NEOLA 2012

EMERGENCY MEDICAL AUTHORIZATION (5341)
Annually, before the first day of October, the Board of Education will
distribute to parents or guardians of all students the Emergency Medical
Authorization Form (Form 5341 F1). Thereafter, the Board shall, within
thirty (30) days after the entry of any student for the first time into a
public school in this State, provide the child's parent with a copy of the
Emergency Medical Authorization Form.

When the Form is returned to the District with either Part I or Part II
completed, the District shall keep the Form on file, and shall send the
Form to any school to which the student is transferred. Upon request of
the student's parent, the District may permit the parent to make changes
in a previously filed Form, or to file a new Form.

In the event emergency medical treatment for a student is necessary, the
District will adhere to the instructions on the authorization form. If a
parent refuses to grant consent for emergency medical treatment, the
parent must indicate in the proper place on the Form (i.e., Part II) the
procedure the parent wishes school authorities to follow in the event of a
medical emergency involving his/her child.

Even if a parent grants consent for emergency medical treatment, when a
student becomes ill or is injured and requires emergency medical
treatment while under school authority, or while engaged in an extra-
curricular activity authorized by the appropriate school authorities, the
building administrator(s) shall make reasonable attempts to contact the
parent before treatment is given. The school representative shall present
the student's Emergency Medical Authorization Form or a copy thereof to
the hospital or practitioner rendering treatment.

The Emergency Medical Authorization Form will be kept in a separate,
easily accessible file in each school building during the school year.

Any time a student or a group of students is taken out of the District to
participate in a school event, the staff in charge of the event must take
the Emergency Medical Authorization Forms for those students. This

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