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FRIENDS ACADEMY SUMMER CAMPS DUCK POND ROAD, LOCUST VALLEY, NY 11560 TEL: (516) 3934207 FAX: (516) 4651720 Medication Authorization Dear Parent/Guardian: In order for medication to be administered
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How to fill out medication authorization - friends?

01
Get a copy of the medication authorization form from your healthcare provider or pharmacy.
02
Read the form carefully to understand the information required and any specific instructions.
03
Fill in your personal details accurately, including your full name, date of birth, and contact information.
04
Provide the name and contact information of your healthcare provider or prescriber.
05
Specify the medication details, including the name, strength, dosage, and frequency of the medication.
06
Indicate the purpose or condition being treated with the medication.
07
If applicable, mention any allergies or sensitivities to medications that your healthcare provider should be aware of.
08
Sign and date the authorization form, acknowledging that you are giving permission for the medication to be released to your designated friend.
09
Make a photocopy of the completed form for your records, if desired.
10
Submit the filled-out form to your healthcare provider or pharmacy as instructed.

Who needs medication authorization - friends?

01
Individuals who are unable to pick up their medications themselves, such as due to illness, disability, or other circumstances.
02
Patients who have designated a trusted friend or family member to assist them with medication management.
03
Anyone who wants to authorize a friend to pick up their medications on their behalf to ensure continuity of care.
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Medication authorization is a written document that allows a designated individual to give consent for administering medication to a friend or loved one.
Typically, a close friend or family member may be required to file medication authorization for their loved one in certain situations.
To fill out a medication authorization form for a friend, one must provide their personal information, details of the medication, dosage instructions, emergency contact information, and any other relevant details.
The purpose of medication authorization is to ensure that a designated individual is legally allowed to administer medication to a friend or loved one in case of an emergency or when the person is unable to do so themselves.
The medication authorization form must include details of the medication being administered, dosage instructions, the recipient's personal information, emergency contact information, and any relevant medical history or allergies.
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