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STUDENT MEDICATION AUTHORIZATION FORM 8 ARCHDIOCESE OF WASHINGTON Catholic Schools NOTE: THIS RELEASE AND INDEMNIFICATION AGREEMENT IS NOT AN AUTHORIZATION FOR AN OR INHALER PART I: TO BE COMPLETED
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How to fill out student medication authorization

How to fill out student medication authorization:
01
Obtain the student medication authorization form from the school or healthcare provider.
02
Fill out the student's personal information, including their full name, date of birth, and school or program they are attending.
03
Provide contact information for both parents or guardians, including phone numbers and email addresses.
04
Indicate the specific medical condition or condition(s) for which the student requires medication.
05
Specify the medication(s) that the student needs to take, including the name, dosage, and frequency.
06
Include any special instructions or additional information regarding the administration of the medication, such as if the student needs to take it with food or if there are any potential side effects.
07
If applicable, provide information on any allergies or other medications that the student is currently taking.
08
Sign and date the authorization form, indicating that you have filled it out accurately and truthfully.
09
Return the completed form to the school or healthcare provider, following any instructions provided.
Who needs student medication authorization?
01
Students who have a medical condition or require medication during school hours.
02
Parents or guardians of these students who want to ensure their child's health and safety while at school.
03
Schools and healthcare providers that need permission and information to administer medication to students.
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What is student medication authorization?
Student medication authorization is a form that allows students to receive medication at school.
Who is required to file student medication authorization?
Parents or legal guardians are required to file student medication authorization forms.
How to fill out student medication authorization?
To fill out student medication authorization, parents or legal guardians must provide information about the student, the medication, and dosage instructions.
What is the purpose of student medication authorization?
The purpose of student medication authorization is to ensure that students can safely receive necessary medication while at school.
What information must be reported on student medication authorization?
Student medication authorization forms must include the student's name, medication name, dosage instructions, administration times, and any potential side effects.
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