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  • Cobb County School District · Web viewSchool Nurse Signature Signature of Witness Author Cobb County School District Created Date 12/18/2012 08:05:00 Title Cobb County School District
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Form JGCD-6 Empowering Dreams for the Future MEDICATION DISPOSAL SHEET School: Year: Dat e Student Name Medicatio n # Pill s or Amt School Nurse Signature Signature of Witness 7/1/08: School Health Services *JGCD-6* Page 1 of 2

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Page 1: Cobb County School District · Web viewSchool Nurse Signature Signature of Witness Author Cobb County School District Created Date 12/18/2012 08:05:00 Title Cobb County School District

Form JGCD-6 Empowering Dreams for the Future

MEDICATION DISPOSAL SHEET

School:       Year:      

Date Student Name Medication# Pills

or Amt

School Nurse Signature Signature of Witness

7/1/08: School Health Services *JGCD-6* Page 1 of 1


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