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This document is a form for obtaining permission and instructions for the administration of prescription medication to students during school hours, requiring completion by both a doctor and a parent/guardian.
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How to fill out school health services prescription
How to fill out School Health Services Prescription Medication Form
01
Obtain the School Health Services Prescription Medication Form from the school office or website.
02
Fill in the student's personal information, including name, date of birth, and grade.
03
Provide the name of the medication, dosage, and frequency of administration as prescribed by the physician.
04
Fill in the purpose of the medication and any special instructions for administration.
05
Include the physician's information, including name, contact number, and signature.
06
Obtain a parent or guardian's signature, indicating consent for the school to administer the medication.
07
Submit the completed form to the school nurse or health services office.
Who needs School Health Services Prescription Medication Form?
01
Students who require medication during school hours.
02
Parents or guardians of students needing medication at school.
03
Healthcare providers prescribing medication for students.
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What is School Health Services Prescription Medication Form?
The School Health Services Prescription Medication Form is a document used by schools to authorize the administration of prescription medications to students during school hours.
Who is required to file School Health Services Prescription Medication Form?
The form must be filed by a parent or guardian of a student who requires prescription medication to be administered during school hours.
How to fill out School Health Services Prescription Medication Form?
To fill out the form, provide the student's personal information, details about the prescribed medication, dosage, administration times, and any special instructions, along with signatures from the parent/guardian and the prescribing physician.
What is the purpose of School Health Services Prescription Medication Form?
The purpose of the form is to ensure that school staff are informed and authorized to safely administer prescription medications to students as needed.
What information must be reported on School Health Services Prescription Medication Form?
The form must report the student's name, date of birth, medication name, prescribed dosage, times for administration, any potential side effects, and the signatures of the parent/guardian and healthcare provider.
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