Get the free request for self-administration of medication during school hours - lausd
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33.205 Eng Rev. 7/12LOS ANGELES UNIFIED SCHOOL DISTRICT
Student Health and Human ServicesREQUEST FOR MALADMINISTRATION OF MEDICATION DURING SCHOOL HOURS
Students Last NameFirst NameSexName of MedicationBirth
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How to fill out request for self-administration of
How to fill out request for self-administration of
01
Start by downloading the self-administration request form from the official website.
02
Fill in your personal details including your name, address, contact number, and email.
03
Provide information about the medication or treatment you require for self-administration.
04
Clearly state the reasons why you need to self-administer the medication or treatment.
05
Attach any supporting documents such as medical reports or prescriptions.
06
Review the completed form to ensure all information is accurate and legible.
07
Sign and date the request form.
08
Submit the request form either by mail or in person to the designated department or authority.
09
Wait for confirmation or further instructions regarding your request.
10
Follow up with the relevant authority if there are any delays or additional requirements.
Who needs request for self-administration of?
01
Anyone who requires a specific medication or treatment and wishes to self-administer it needs to fill out a request for self-administration. This can include individuals with chronic illnesses, disabilities, or those who need to administer medication on a regular basis. The request allows them to take responsibility for their own healthcare and ensure timely access to necessary treatments.
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What is request for self-administration of?
Request for self-administration is for requesting permission to handle one's own medications or medical treatments without assistance.
Who is required to file request for self-administration of?
Individuals who wish to self-administer medications or medical treatments are required to file the request.
How to fill out request for self-administration of?
To fill out the request, individuals must provide necessary personal information, details of medications or treatments, and any relevant medical history.
What is the purpose of request for self-administration of?
The purpose of the request is to ensure that individuals can safely and effectively self-administer their medications or medical treatments.
What information must be reported on request for self-administration of?
The request must include personal information, details of medications or treatments, medical history, and any potential risks or side effects.
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