>

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 Vanderbilt 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.

Youth Program Leader Medical Forms Decision Treee

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) for 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. 
  • 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: Observed Medication Administration Training and EpiPen Auto-Injector Instructions. 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. 

Additional Questions?

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