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S9: Student Medication Form
STUDENT INFORMATION
Student Name:Date of Birth:Address:City:Home Phone:School:
State:Mobile Phone:Zip:Email:EMERGENCY CONTACT INFORMATION
Name (other than parent/guardian):Phone:PARENT/GUARDIAN
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How to fill out s-9 student medication form

How to fill out s-9 student medication form
01
To fill out the S-9 student medication form, follow these steps:
02
Start by reading the instructions provided with the form.
03
Fill in the student's name, date of birth, and grade level.
04
Provide the contact information of the student's parent or guardian.
05
Write down any known allergies or medical conditions that the student has.
06
Specify the medication that needs to be administered, including the name, dosage, and frequency.
07
Indicate whether the medication needs to be given during school hours or if it can be self-administered.
08
Include any special instructions or precautions for administering the medication.
09
Sign and date the form, either as the parent/guardian or as the physician prescribing the medication.
10
Submit the completed form to the appropriate school personnel or healthcare administrator.
Who needs s-9 student medication form?
01
The S-9 student medication form is needed for any student who requires medication to be administered during school hours.
02
This includes students with chronic health conditions, allergies, or other medical needs.
03
The form helps ensure that the school staff are aware of the student's medication requirements and can provide the necessary support and monitoring.
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