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This document authorizes the administration of medication to students by school personnel, in accordance with Connecticut State Law, requiring written orders from licensed physicians and consent from
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How to fill out authorization for form administration
How to fill out Authorization for the Administration of Medicine by School Personnel
01
Obtain the Authorization for the Administration of Medicine form from the school or school district's website.
02
Fill in the student's full name, date of birth, and grade level at the top of the form.
03
Provide the name of the medication, dosage, and the frequency at which it should be administered.
04
Include the specific times the medication needs to be administered during school hours.
05
Obtain a physician's signature and date on the form to confirm the need for the medication.
06
Have a parent or guardian sign the authorization section, giving permission for school personnel to administer the medication.
07
Return the completed form to the school's health office or designated personnel.
Who needs Authorization for the Administration of Medicine by School Personnel?
01
Students who require medication during school hours for conditions such as allergies, asthma, diabetes, or other health issues.
02
Parents or guardians of students needing medication administration at school.
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What is Authorization for the Administration of Medicine by School Personnel?
Authorization for the Administration of Medicine by School Personnel is a formal agreement that allows designated school staff to administer medication to students during school hours, ensuring that students who require medication for health conditions receive it as prescribed.
Who is required to file Authorization for the Administration of Medicine by School Personnel?
Typically, parents or guardians of students who need to take medication during school hours are required to file this authorization, along with a healthcare provider's prescription or document indicating the need for medication.
How to fill out Authorization for the Administration of Medicine by School Personnel?
To fill out the authorization, parents or guardians should complete the designated form provided by the school, including the student's information, the name and dosage of the medication, administration times, and any specific instructions, along with signatures from both the parent/guardian and the healthcare provider.
What is the purpose of Authorization for the Administration of Medicine by School Personnel?
The purpose is to ensure that students receive the necessary medication safely and effectively during school hours, while also protecting school personnel from liability by having a clear, written agreement regarding medication administration.
What information must be reported on Authorization for the Administration of Medicine by School Personnel?
The form must report the student's name, date of birth, medication name, dosage, timing of administration, possible side effects, parent/guardian contact information, and verification from a healthcare provider.
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