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Washington School Medication Authorization (OSPI)

Washington schools need a written request from a licensed healthcare provider with prescriptive authority, plus parent authorization, before staff give a student medication under RCW 28A.210.260. OSPI publishes this Word template as a sample that districts adapt. The provider lists the drug, dose, schedule and reason, and the signed form goes to the school nurse for the authorized period.

Who completes it

The student's licensed healthcare provider with prescriptive authority completes and signs the Licensed Healthcare Provider Request section. The parent or guardian completes and signs the Parent/Guardian Request section above it.

Submitting and payment

How to submit it
The family returns the signed form to the school nurse. A separate form is needed for each medication, and a responsible adult must carry the medication to and from school.
Who pays
The sample form sets no fee and does not say who pays for the provider's section.

Good to know

  • The form covers both prescription and nonprescription medication, so an over-the-counter drug given at school still needs the provider's signed request.
  • Further instructions, such as possible reactions, must be completed whenever the medication will be given for more than 15 days.
  • The parent and the provider each enter a start date and either a termination date or the end of the school year, with a yes or no for summer school activities.
  • OSPI marks the form as a sample (revised 08/2023), so a district may use its own adapted version; the school nurse can say which one the school expects.

Get the official form

Download the current version from the source each time; forms change without notice.

Authorization to Administer Medication at School

Official pageWord file

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Frequently asked questions

Does a Washington school need a provider's order for over-the-counter medicine?

Yes, on this form. OSPI's sample authorization states it is for both prescription and nonprescription medication and must be signed by the parent or guardian and by a licensed healthcare provider with prescriptive authority. A separate form is completed for each medication the student takes at school.

How long is the Washington school medication authorization valid?

For the period written on the form. The provider and the parent each enter a start date and either a termination date or the end of the school year, and mark whether the authorization also covers summer school activities. The parent also states whether the child should take the medication at school on half-day schedules.

What does the Licensed Healthcare Provider Request section ask for?

The medication name and dosage, the administration schedule, the reason for the medication and further instructions such as possible reactions, which are required when the medication runs longer than 15 days. The provider then dates and signs the request and adds an office phone and printed name.