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Superintendent File: JLCD-E-1 Student Medication Request and Release Agreement Student: DOB: School Year Name of Medication Epinephrine Auto Injector* *If Colorado State Anaphylaxis Health Care Plan

How to fill out student medication request and

How to fill out a student medication request and:

1. Start by obtaining the appropriate form. This could be available from your school's health office or through an online platform.
2. Fill out the student's personal information section, including their name, date of birth, grade, and contact information. Ensure all details are accurate and up to date.
3. Indicate the specific medication being requested. Provide the name, dosage, and any other relevant details. If there are multiple medications, fill out separate sections for each one.
4. Specify the reason for the medication request. This could include allergies, chronic conditions, or occasional needs. It is important to provide detailed information to ensure accurate and safe administration.
5. If necessary, include any special instructions or precautions. This could involve details about timing, storage requirements, potential side effects, or any other relevant information.
6. If the medication requires administration during the school day, indicate the dosage schedule. Include details such as the frequency of administration, specific times, and any additional instructions.
7. If the student needs to self-administer the medication, make sure to mention this on the form. Include any specific instructions or requirements for the school staff to facilitate this.
8. Review the completed form thoroughly to avoid any errors or missing information. Double-check all sections and ensure everything is legible. Any missing or incomplete information may delay the approval or administration of the requested medication.

Who needs a student medication request and:

1. Students with ongoing medical conditions that require regular medication during school hours. This could include conditions such as asthma, diabetes, epilepsy, or severe allergies.
2. Students with short-term medical needs, such as recovering from surgery or an injury. In such cases, a temporary medication request might be necessary.
3. Students who require medication for occasional emergencies, such as an asthma inhaler or an EpiPen for severe allergic reactions.

Remember, each school may have specific policies and procedures in place for submitting and processing student medication requests. It is essential to follow these guidelines and communicate with the appropriate school personnel to ensure a smooth and efficient process.

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What is student medication request?

A student medication request is a form that allows students to request to have medication administered during school hours.

Who is required to file student medication request?

The student's parent or guardian is required to file the student medication request form.

How to fill out student medication request?

To fill out the student medication request, the parent or guardian must provide information about the student, the medication to be administered, dosage instructions, and any special instructions.

What is the purpose of student medication request?

The purpose of the student medication request is to ensure that students receive necessary medication in a safe and timely manner while at school.

What information must be reported on student medication request?

The student's name, date of birth, medication name, dosage, administration instructions, and emergency contact information must be reported on the student medication request.