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DENVER PUBLIC SCHOOLS DIVISION OF STUDENT SERVICES NURSING & STUDENT HEALTH SERVICES 2009/2010 School: Phone: FAX: STUDENT MEDICATION REQUEST RELEASE AGREEMENT The undersigned parent(s) or guardian(s)
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How to fill out student medication request release
How to fill out a student medication request release:
01
Begin by obtaining a copy of the student medication request release form. This form is typically provided by the school or educational institution.
02
Fill in the personal information section of the form, including the student's full name, date of birth, grade or class, and contact details. Ensure that all the information is accurate and up to date.
03
In the next section, specify the medication details. This includes the name of the medication, dosage instructions, and any special instructions or precautions. If there are multiple medications, list them separately.
04
Provide the reasons for administering the medication at school. This could include a medical condition or necessary treatment that requires medication during school hours.
05
If required, include the healthcare provider's details, such as the name, address, and contact information. This is important for verification purposes and to ensure that the school can reach out to the healthcare provider if needed.
06
Read through the terms and conditions section carefully. Ensure that you understand any consent or liability statements mentioned in this section. If you have any questions or concerns, don't hesitate to reach out to the school or healthcare provider.
07
Finally, sign and date the form. If there are additional signatures required, ensure that they are obtained from all relevant parties, such as the parent or guardian, student, and healthcare provider.
Who needs a student medication request release:
01
Students who require medication administration during school hours due to a medical condition or necessary treatment.
02
Parents or legal guardians of the student who need to provide consent for the administration of medications at school.
03
Healthcare providers who are responsible for prescribing and overseeing the medication for the student.
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What is student medication request release?
Student medication request release is a form that allows students to receive medication at school.
Who is required to file student medication request release?
Parents or guardians of the student are required to file student medication request release.
How to fill out student medication request release?
To fill out student medication request release, parents or guardians must provide information about the student's medication, dosage, and schedule.
What is the purpose of student medication request release?
The purpose of student medication request release is to ensure that students receive necessary medication at school in a safe and responsible manner.
What information must be reported on student medication request release?
Student medication request release must include the student's name, medication name, dosage, schedule, and any special instructions.
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