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SCHOOL HEALTH SERVICES
Medication Authorization Form
PLEASE READ CAREFULLY:
As outlined in the Nurse Practice Act and Provisions of the State Education Law, School Nurses,
Teachers, Principals and
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How to fill out school health services medication

How to fill out school health services medication:
01
Obtain the medication form: Contact your school's health services office to obtain the necessary medication form. This form typically requires important details such as the student's name, school information, and the specific medication being administered.
02
Fill out student information: Enter the student's full name, date of birth, grade level, and any other required personal information on the medication form. It is essential to provide accurate and up-to-date details to ensure proper administration and safety.
03
Specify medication details: Clearly state the name of the medication being administered, dosage instructions, and frequency of administration. Include any additional instructions or special considerations, such as whether the medication needs to be taken with food or at a specific time of day.
04
Include pertinent medical information: Provide relevant medical information, such as known allergies, current medical conditions, and any side effects or potential drug interactions that should be taken into account. This information helps ensure the safe administration of medication and allows the school's health services staff to provide appropriate care.
05
Obtain necessary signatures: The medication form typically requires signatures from both the parent or guardian and the prescribing healthcare provider. Make sure to sign and date the form in the designated areas.
06
Provide additional documentation if required: Some schools may require additional documentation, such as a prescription label or a healthcare provider's note. If any supplementary documents are needed, make sure to attach them securely to the medication form.
Who needs school health services medication?
01
Students with chronic illnesses: Students who have chronic illnesses or medical conditions may require regular medication administration during school hours. This could include conditions such as asthma, diabetes, epilepsy, or severe allergies.
02
Students with short-term medical needs: Temporary medical conditions, like recovering from surgery or needing antibiotics for an infection, may also necessitate medication administration at school. In such cases, it is important to communicate with the school's health services office and ensure proper documentation is provided.
03
Students with special medical needs: Some students may have special medical needs that require medication during school hours, even if they do not have a chronic illness. For instance, students with ADHD may need to take medication to manage their symptoms and improve focus in the classroom.
Note: It is crucial to consult with your school's health services office and healthcare provider for specific guidelines and instructions related to filling out school health services medication forms and determining who needs medication administration at school.
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What is school health services medication?
School health services medication refers to the medications administered by school health personnel to students during school hours to manage their health conditions.
Who is required to file school health services medication?
Parents or guardians of students who require medication to be administered at school are required to file school health services medication.
How to fill out school health services medication?
Parents or guardians can fill out school health services medication forms provided by the school, indicating the student's name, the name and dosage of the medication, and any specific instructions for administration.
What is the purpose of school health services medication?
The purpose of school health services medication is to ensure that students with health conditions receive the necessary medications and support during school hours to manage their health effectively.
What information must be reported on school health services medication?
School health services medication forms typically require information such as the student's name, the medication name and dosage, administration instructions, parent/guardian contact information, and physician approval.
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