Schulverein der Kreuzschwestern
LISA-JUNIOR
International Primary School
Aubrunnerweg 43, 4040 Linz
office@lisa-junior.at
www.lisa-junior.at
AUTHORIZATION
FOR ADMINISTERING POTASSIUM IODODE TABLETS
Dear Parents,
Potassium iodide tablets are an important precautionary measure for protecting your child
from thyroid cancer in the event of a nuclear accident.
You have probably already received free potassium iodide tablets from your pharmacy. You
can protect your child effectively at home by giving him/her these tablets upon order of the
public health authorities.
If a nuclear accident were to happen during teaching hours, your child would be given the
first daily dose at school.
Please read the attached explanatory leaflet carefully before giving your permission!
Sincerely,
Gabriele Untersperger
Principal
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AUTHORIZATION
FOR ADMINISTERING POTASSIUM IODODE TABLETS
Name of the student _________________________________________________________
Date of birth _______________________________________________________________
Name of parents/the guardian__________________________________________________

YES, I hereby give my permission for the school to administer potassium iodide tablets
to my child in the event of a nuclear accident upon order of the public health authorities
and I confirm that my child does not suffer from any intolerances and adverse reactions
to potassium iodide tablets. (See explanatory leaflet for parents!)

NO, I don’t give my permission for the school to administer potassium iodide tablets to
my child.