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Providence Academy Medication×Supplements×Oils An Independent Christian School in Leesburg, VA www.providenceacademyva.org 20162017 Student Name×Grade×Homeroom: Student Weight: DOB: Known Allergies:
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How to fill out a student medications form:

01
Start by carefully reading the instructions on the form. Make sure you understand all the information that is required.
02
Provide the student's personal details, such as their full name, date of birth, and contact information. This will ensure that the form is correctly identified with the correct student.
03
Fill in details about the medications the student requires. Include the name of the medication, dosage instructions, and any special instructions or comments from the prescribing doctor or healthcare professional.
04
Note any allergies or adverse reactions the student may have. This is crucial information for healthcare providers in case of emergencies or when administering other medications.
05
Include information about the student's primary healthcare provider, such as their name, contact information, and any specific instructions regarding the management of the student's medications.
06
If the student requires medication administration during school hours, specify the desired schedule and method of administration. This could include whether the student self-administers, requires assistance from a school nurse or designated staff member, or needs to visit the school's health office.
07
Ensure that both the student and their parent or guardian sign and date the form. This verifies that all the information provided is accurate and complete.
08
Return the completed form to the appropriate school personnel, such as the school nurse or administrative office, following the specified instructions or deadline.

Who needs a student medications form:

01
Students who require medication administration during school hours need a student medications form. This could include students with chronic conditions, such as asthma or diabetes, who may require regular medication.
02
Students with severe allergies or other medical conditions that may require emergency medication, like an epinephrine auto-injector, should also have a student medications form on file.
03
It is important for schools to have up-to-date and accurate information about any medications a student may require in case of emergencies or daily management. Therefore, any student who takes prescription or over-the-counter medication during the school day should have a completed student medications form.
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The student medications form is a document used to record and report the medications that a student is required to take during school hours.
Parents or guardians of students who need to take medications during school hours are required to file the student medications form.
To fill out the student medications form, parents or guardians need to provide details of the student, the name and dosage of the medication, and any instructions for administration.
The purpose of the student medications form is to ensure that school staff are aware of any medications that students need to take during school hours and to provide guidelines for administering them.
The student medications form must include the student's name, age, grade, the name and dosage of the medication, instructions for administration, and any potential side effects.
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