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HEALTH SERVICES * P.O. Box 2019, Appleton, WI 54911 × 9209971399 ext. 2106 AUTHORIZATION FOR MALADMINISTRATION OF MEDICATIONS IN THE SCHOOL SETTING Note: Return the completed form to the main office.
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How to fill out authorization for self-administration of:

01
Start by writing your full name and contact information.
02
Include relevant medical information, such as any existing conditions or allergies.
03
Indicate the medications that you are authorized to self-administer, including the dosage and frequency.
04
Provide details on the method of administration for each medication, whether it's oral, inhalation, injection, etc.
05
If necessary, include any special instructions or precautions to be taken while self-administering the medication.
06
Sign and date the authorization form.

Who needs authorization for self-administration of:

01
Individuals who have been prescribed medication that can be safely self-administered may need authorization.
02
This can include patients with chronic illnesses or conditions that require regular medication administration.
03
It is important to consult with a healthcare professional to determine if self-administration is suitable for your specific situation and if authorization is required.
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Authorization for self-administration of is for allowing individuals to administer medication or medical treatments to themselves.
The individuals who will be self-administering medication or medical treatments are required to file authorization for self-administration of.
Authorization for self-administration of can be filled out by providing personal information, details of medication or treatment, and any necessary instructions.
The purpose of authorization for self-administration of is to ensure that individuals can safely administer medication or medical treatments to themselves.
Information such as the name of the individual, type of medication or treatment, dosage, frequency, and any special instructions must be reported on authorization for self-administration of.
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