NY Asthma Medication Administration Form 2014 free printable template

MEDICATION ADMINISTRATION FORM OFFICE OF SCHOOL HEALTH. Authorization for Administration of Medication to Students for School Year 2014 2015.

How to fill out NY Asthma Medication Administration Form

How to fill out NY Asthma Medication Administration Form

1. Obtain the NY Asthma Medication Administration Form from your school or healthcare provider.
2. Fill in the student's full name at the top of the form.
3. Provide the student's date of birth and grade/class information.
4. Specify the name of the asthma medication to be administered.
5. Indicate the dosage and frequency of the medication as prescribed by a physician.
6. Include the physician's name, contact information, and signature.
7. Obtain a parent or guardian's signature to authorize the administration of the medication.
8. Review the completed form for accuracy and completeness before submitting it to the school.

Who needs NY Asthma Medication Administration Form?

1. Students with a diagnosed asthma condition who require medication during school hours need the NY Asthma Medication Administration Form.
2. Parents or guardians of these students must complete and submit the form to ensure the school can administer the medication safely.

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What is NY Asthma Medication Administration Form?

The NY Asthma Medication Administration Form is a legal document that allows school personnel to administer asthma medication to students during school hours.

Who is required to file NY Asthma Medication Administration Form?

The form must be filed by parents or guardians of students who require asthma medication while at school.

How to fill out NY Asthma Medication Administration Form?

To fill out the form, parents or guardians should provide the student's information, details of the asthma medication, dosage, and the conditions under which it should be administered, along with signatures from both the parent and the prescribing healthcare provider.

What is the purpose of NY Asthma Medication Administration Form?

The purpose of the form is to ensure that students with asthma can receive necessary medications safely and legally during school hours.

What information must be reported on NY Asthma Medication Administration Form?

The form must report the student's name, date of birth, medication name, dosage, administration route, times medication should be administered, and contact information for the parent and doctor.