Get the free PARENT CONSENT MEDICATION AUTHORIZATION FORM Complies

PARENT CONSENT/ MEDICATION AUTHORIZATION FORM Complies with 606 CMR 7.11(2)(b) Top portion must be filled out by prescribing physician One form per medication Name of Child: DOB Name of Medication:

How to fill out parent consent medication authorization

How to fill out parent consent medication authorization:

1. Obtain the necessary form: Contact your child's school or healthcare provider to obtain the parent consent medication authorization form. It may also be available online on their website.
2. Fill in personal information: Start by providing your child's full name, date of birth, and contact information. Include your own name as the parent or legal guardian and provide your contact details as well.
3. Specify the medication details: Write down the name of the medication that your child requires, along with the dosage and frequency instructions. If there are any specific instructions regarding the administration of the medication, make sure to mention them as well.
4. Indicate the authorized individuals: In this section, you will need to list the people who are authorized to administer the medication to your child. This may include school nurses, teachers, or other designated personnel. Include their names and positions or titles.
5. Note any allergies or special instructions: If your child has any known allergies or specific instructions related to the medication, make sure to provide them in this section. This helps ensure that the medication is administered safely and effectively.
6. Fill in the date and sign: At the end of the form, write down the date of completion and your signature as the parent or legal guardian. By signing, you are giving your consent and acknowledging your understanding of the medication authorization.

Who needs parent consent medication authorization:

1. Students with chronic medical conditions: If your child has a chronic medical condition that requires them to receive medication during school hours, they will likely need a parent consent medication authorization. This ensures that the school staff or healthcare providers are aware of the medication needs and can administer them safely.
2. Students with short-term medication needs: Even if your child only requires short-term medication, such as antibiotics or pain relievers, a parent consent medication authorization may still be necessary. It helps communicate the medication details and any specific instructions to the school or healthcare provider.
3. Students participating in off-site activities: If your child will be participating in off-site activities, such as field trips or sports events, where medication administration may be required, a parent consent medication authorization is typically required. This ensures that the authorized individuals are aware of the medication needs while your child is away from the school premises.

For pdfFiller’s FAQs

What is parent consent medication authorization?

Parent consent medication authorization is a form that gives permission for a child to receive medication at a school or childcare facility.

Who is required to file parent consent medication authorization?

Parents or legal guardians of the child are required to file parent consent medication authorization.

How to fill out parent consent medication authorization?

Parent consent medication authorization can be filled out by providing necessary information about the child, medication details, dosage instructions, and parent/guardian signature.

What is the purpose of parent consent medication authorization?

The purpose of parent consent medication authorization is to ensure that children receive proper medication in a safe and authorized manner.

What information must be reported on parent consent medication authorization?

Parent consent medication authorization must include child's name, date of birth, medication details, dosage instructions, parent/guardian contact information, and signature.

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