Get the free Medication Authorization Form - Good Shepherd Catholic School - gsschool

Diocese of Monterey Physician Order and Parental Authorization to Administer Medication In order for a student to receive medication at school or during school-related activities, the following criteria

How to fill out medication authorization form

How to fill out a medication authorization form:

1. Start by gathering all the necessary information. This includes the patient's full name, date of birth, address, and contact information.
2. Next, provide details about the healthcare provider. This may include the name of the physician or healthcare facility, their contact information, and any relevant identification numbers.
3. Specify the medication that requires authorization. Include the name of the medication, dosage instructions, and the reason for the prescription.
4. If applicable, provide any additional instructions or details. This could involve explaining special circumstances, such as allergies or specific administration methods.
5. Review the form to ensure all the required sections are filled out accurately and completely.
6. Sign and date the authorization form. Depending on the requirements, you may need to have a witness or have the form notarized.
7. Keep a copy of the medication authorization form for your records.
8. Submit the completed form to the appropriate recipient, such as a pharmacy or healthcare provider.

Who needs a medication authorization form:

1. Patients who require or are prescribed medication that requires authorization.
2. Caregivers or guardians responsible for the medication administration of individuals, such as children or elderly individuals incapable of managing their own medications.
3. Healthcare providers who need to communicate and coordinate medication administration for their patients with other medical professionals or institutions.

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