Get the free Non-Prescription Medication Administration Request

Solomon Lutheran Church & School 305 W. Main Street, Woodpile, Ohio 43469 Phone: (419× 8493600 FAX: 4198492260 Nonprescription Medication Administration Request Student Name Grade Name of Medication

How to fill out non-prescription medication administration request

How to fill out non-prescription medication administration request:

1. Start by obtaining the non-prescription medication administration request form from the appropriate source, such as a doctor's office or pharmacy.
2. Fill in your personal information on the form, including your full name, date of birth, and contact information. This information is necessary for identification purposes.
3. Indicate the medication you are requesting administration for. Write down the name of the medication, the dosage, and any specific instructions provided by your healthcare provider or pharmacist.
4. If applicable, provide details on the frequency and duration of medication administration. This could include instructions such as "take once daily for two weeks" or "apply topically twice a day for one month."
5. Include any relevant medical history that may be necessary for the healthcare provider or pharmacist to know. This could include allergies, previous adverse reactions to medications, or current health conditions.
6. If the non-prescription medication requires authorization from a healthcare provider, provide their contact information on the form. This allows the pharmacist or healthcare provider to verify the request if needed.
7. Consider including any additional information that may be important, such as any other medications you are currently taking or any concerns or questions you may have about the non-prescription medication.

Who needs non-prescription medication administration request:

1. Individuals who require non-prescription medication for various health conditions may need to fill out a non-prescription medication administration request. This includes individuals who may need over-the-counter pain relievers, allergy medication, cold and flu remedies, or topical creams for various skin conditions.
2. Non-prescription medication administration requests may also be necessary for individuals who require certain self-administered treatments, such as eye drops, nasal sprays, or inhalers.
3. Additionally, healthcare facilities, such as nursing homes or schools, may require non-prescription medication administration requests for their residents or students to ensure proper documentation and administration protocols. This helps to ensure the safety and well-being of individuals receiving non-prescription medications in these settings.

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