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Tabernacle School
Authorization for Medication to be Given During School Hours
(This form is to be used for both prescription and overthecounter medications.)
The administration of medication to students
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How to fill out authorization for medication to

How to fill out authorization for medication to:
01
Start by writing your full name and contact information at the top of the form.
02
Indicate the medication for which you are seeking authorization by writing its name, dosage, and any specific instructions or conditions.
03
Provide information about the prescribing physician, including their name, contact details, and their medical license number.
04
If applicable, include any relevant medical history or conditions that may impact the authorization process.
05
Sign and date the form at the designated area to acknowledge that the information provided is accurate and complete.
Who needs authorization for medication to:
01
Patients who require prescription medication that is not available over the counter.
02
Individuals who need medications that are controlled substances.
03
Patients who require medications that have specific usage restrictions or require close monitoring.
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What is authorization for medication to?
Authorization for medication is to obtain permission to administer or dispense medication to a specific individual.
Who is required to file authorization for medication to?
Healthcare professionals or caregivers who are responsible for administering or dispensing medication to a patient are required to file authorization for medication.
How to fill out authorization for medication to?
Authorization for medication can be filled out by providing details such as patient's name, medication name, dosage, frequency, duration, physician's name, and signature.
What is the purpose of authorization for medication to?
The purpose of authorization for medication is to ensure safe and proper administration of medication to the patient.
What information must be reported on authorization for medication to?
Information such as patient's name, medication name, dosage, frequency, duration, physician's name, and signature must be reported on authorization for medication.
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