My school had no nurse before I came. I was able to call the next county over and they gave me their protocols. I got a physician whose children attended the school to sign off, but he was also the HD doc, so he would have been the person to sign off anyway. Public schools in my county have no protocols, save the state law regarding stock epi. OTCs are a blessing and a curse, as I only give them if the parents OK it in our system. It is really a hassle at times. Check with your health department, they may be your oversight.