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Forms & Resources for Program Leaders

Program Operations Policy Handbook, Forms, and Other Resources

Youth Program Health and Medication Forms and Processes

To improve best practices and university-wide standards for youth programs, participation in ¹ú²úÔ­´´ youth programs requires parents to complete standardized medical forms related to the health of their child and to inform program leaders of any critical and ongoing health concerns and conditions. The following procedures apply to all VU youth programs (day and residential). Template forms related to health and medication management are included for use in the event registration process. In addition, all programs should include relative physical and mental health questions for parent/guardian response in the registration process and include a clear program description to help parents gauge the ability of their child to be successful in the activities.

Click the Youth Program Leader Medical Forms Decision Tree image below to see it full size.

  • Starting Point

    Use the to begin the process.

  • Health, Wellness and Medication Policies for VU Personnel to Review

    FAQÌýavailable for additional guidance.

  • Medication Packet Templates for Parent/Guardian
    • Ìý(parent completes): Provided in MS Word.
    • Ìý(parent and health care provider completes if any prescription medication comes to program): Provided in MS Word.
    • Ìý(must be completed by parent and health care provider): Provided in MS Word.
    • : For parent completion. Programs should also gather why the exception is being requested.
    • (use requires training to be complete in Oracle).
  • Exceptions Process for Vaccinations and Unexpected Medications at Check-In/During Program

    Exemptions Request to Youth Program Medication Policies

    Should a parent request an exception for their child to any of the medication policies in day or residential programs:

    1. Review the appropriate guidance and policy above and if there is a request or special circumstance requiring a clinical review.
    2. Complete the Ìýrequest.

    SeeÌýFAQÌýfor examples.

    Note: Form is to be completed by VU Program Personnel Only

    This form should only be used if medication non disclosed is discovered at check in or during any part of the program activities. This is to be completed by a parent/guardian.

  • Health & Wellness Training Links
    • Ìýin Oracle
    • First Aid/CPR training is available through Premedics: training@premedics.com (approved vendor for VU) for designated health and wellness program personnel (see Checklist personnel requirements)Ìý
    • Heath and WellnessÌý
    • YouthÌý: This is an external resource for training program personnel to manage circumstances and situations related to youth mental health

Youth Programs Health and Medication Policies FAQ

  • What Do I Do if a Day Program Participant Requires a Non-rescue Medication During Program Hours?

    Gather necessary information from the participant’s parent and submit an exemption request to the clinical review team. Prior to submitting, it is important to ask the parent:

    1. Is it possible to alter the administration time to before or after the program?
    2. Will failure to take the medication during program hours jeopardize the health of the Participant?

    Note: The exemption form should only be submitted to the clinical review team from a program faculty or staff member (not a parent/legal guardian)

  • What Do I Do if a Participant Presents With a Medication That Isn’t Listed on Their Medication Information Form?

    The parent or legal guardian will need to fill out a Temporary Medication Authorization Form, see the "Exceptions Process and Unexpected Medications at Check-In/During Program" section above.

  • Our Program Doesn’t Stock Over the Counter Medication. If a Participant Complains of a Headache and One of Our Staff Members Has Tylenol in Their Bag, Can We Offer It to the Participant?

    You cannot provide a participant with any medication, including over the counter medication. This is a safety and liability risk.

  • Do All Prescription Medications Need to Be Stored by Residential Programs?

    Some prescription medication, including emergency and rescue medication, can be stored by residential program participants. See "Appendix A" in the Medication Management Checklist (found in the "Starting Point" section on this page)Ìýfor a list of medications that have been pre-approved for participant storage.

  • Can Over the Counter Medication Be Stored by the Participant of a Residential Program?

    Yes, over the counter medication can be stored by the participant of a residential program if their parent/legal guardian gives authorization on their medication forms. If the parent/legal guardian elects for over-the-counter medication to be stored by the program, the program will need to honor their request, regardless of the Participant’s age.

  • If Medication Is Being Stored by the Participant of Any Program, Do I Need to Log the Self Administration?
    • Only emergency and rescue medication being stored by the participant will need logged. Additional information regarding medication standards can be found in the Health, Wellness and Medication policies.Ìý
  • What Should I Do if I’m Unfamiliar With an Emergency or Rescue Medication Listed on the Medication Information Forms?

    If at anytime you’re unfamiliar or have questions about a medication being brought to your program, please contact Amy Silvers in Health and Wellness at amy.e.silvers@vanderbilt.edu for additional information.

  • What Designated Staff Training Is Required for Programs?

    All programs will designate a minimum of 2 staff members for the oversight of medication self-administration. Designated staff will also carry, store, and transport medication as needed. Assure they have completed and reviewed the following: and . Residential programs must have at least two supervising adults to have received First Aid and CPR. It is highly encouraged, but optional for day programs to have staff with First Aid and CPR training. See the Medication Management Checklist in the "Starting Point" section of this page for more information.Ìý

Additional Questions?

Please contact us at protectionofminors@vanderbilt.edu or call 615.936.5935