Get the free parent/guardian request for medication assistance ccsd personnel...

Clark County School District Health Services Department9998500643 CCF643Rev. 11/16PARENT/GUARDIAN REQUEST FOR MEDICATION ASSISTANCE SCHOOL YEAR Name of Student (please print): Birthdate: Teacher:

How to fill out parentguardian request for medication

How to fill out parentguardian request for medication

1. Begin by downloading the parent/guardian request for medication form from the school's website or obtaining a physical copy from the school office.
2. Read the instructions on the form carefully to understand the requirements and guidelines for filling out the form.
3. Fill in the child's personal information such as name, date of birth, and grade level.
4. Provide details about the medication, including the name, dosage, frequency, and administration instructions.
5. Indicate the reason for the medication and any specific health conditions that require its administration.
6. If the medication needs to be administered at school, mention the specific times and any special instructions regarding storage or transportation.
7. Check the appropriate box indicating whether the medication can be self-administered by the student or if it requires assistance from a school staff member.
8. Sign and date the form, indicating your consent and understanding of the responsibility associated with providing medication.
9. Submit the completed form to the school office or the designated personnel as instructed.
10. Keep a copy of the filled-out form for your records.

Who needs parentguardian request for medication?

1. A parent or guardian needs to fill out the parent/guardian request for medication form if their child requires any medication to be administered during school hours.

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What is parent/guardian request for medication?

Parent/guardian request for medication is a form that allows parents or guardians to request the administration of medication to their child while at school.

Who is required to file parent/guardian request for medication?

Parents or guardians are required to file parent/guardian request for medication if they want their child to receive medication while at school.

How to fill out parent/guardian request for medication?

Parents or guardians can fill out the parent/guardian request for medication form by providing their child's information, details of the medication, dosage instructions, and any other relevant information.

What is the purpose of parent/guardian request for medication?

The purpose of parent/guardian request for medication is to ensure that the school staff are aware of the medication needs of the students and can administer it safely if required.

What information must be reported on parent/guardian request for medication?

Parent/guardian request for medication must include the child's name, date of birth, details of the medication, dosage instructions, potential side effects, emergency contact information, and any special instructions.