WA Coulee-Hartline School District Medication Authorization 2006-2025 free printable template

Coulee Hartline School District Medication Authorization For Oral and Emergency Injected Medication Administration at School Student Name: Birth Date: School: Coulee Hartline School District Grade:

How to fill out WA Coulee-Hartline School District Medication Authorization

How to fill out WA Coulee-Hartline School District Medication Authorization

1. Obtain the WA Coulee-Hartline School District Medication Authorization form from the school office or the district website.
2. Fill out the student's personal information at the top of the form, including name, grade, and date of birth.
3. Indicate the name of the medication to be administered during school hours.
4. Provide the dosage and frequency of the medication as prescribed by the student's healthcare provider.
5. Complete the section for the healthcare provider’s information, including their name, contact number, and signature.
6. Include parent or guardian information and their signature, giving permission for school staff to administer the medication.
7. Double-check all entries for accuracy and completeness.
8. Submit the completed form to the school office along with the medication in its original packaging.

Who needs WA Coulee-Hartline School District Medication Authorization?

1. Any student who requires medication during school hours, including prescription and over-the-counter medications.
2. Students with chronic health conditions that necessitate medication management at school.
3. Parents or guardians of students who need to authorize their child's medication administration at school.

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What is WA Coulee-Hartline School District Medication Authorization?

WA Coulee-Hartline School District Medication Authorization is a formal document that allows students to receive prescribed medication during school hours, ensuring their health and safety.

Who is required to file WA Coulee-Hartline School District Medication Authorization?

Parents or guardians of students who need medication during school hours are required to file the WA Coulee-Hartline School District Medication Authorization.

How to fill out WA Coulee-Hartline School District Medication Authorization?

To fill out the WA Coulee-Hartline School District Medication Authorization, parents must complete the form with details about the medication, dosage, frequency, and signatures from both the parent and the prescribing physician.

What is the purpose of WA Coulee-Hartline School District Medication Authorization?

The purpose of the WA Coulee-Hartline School District Medication Authorization is to ensure that students who require medication during school hours receive it safely and correctly, while complying with school policies.

What information must be reported on WA Coulee-Hartline School District Medication Authorization?

The information that must be reported includes the student's name, medication name, dosage, route of administration, prescribing physician's details, parent or guardian contact information, and any specific instructions for administration.