Ruth Card, RN
Hometown Middle School
Dear Ms. Card
I am hereby granting permission, through this letter, for your office at the Hometown Middle School to dispense the following medications for my child on an as needed basis. My son's name is Tybias Forbes
For headaches and basic pain - Acetaminophen (no aspirin as he is allergic to it) For colds and allergies you can give him Benadryl or something similar to it For an upset stomach he can have Pepto-Bismol but no tablets as he cannot digest them
This last time it was not. Fortune Insurance allows a copayment of $15 for use of generic drugs to fill prescriptions. They charge a sliding scale of up to $45 for name brand drugs. I am guessing my husband did not notice the charge when he picked up the prescription for me. I do not like paying for pretty little pills and fancy TV advertising.
I have checked with our family doctor, Dr. Peter Rose, who has given his approval of all named medication for our son.
S. Leah Forbes