WV Early Childhood Child Care Medication free printable template

Child Care Medication Authorization Form Name of Child: D.O.B.: Today s Date: Name of Medication: Reason for Medication: Dose: Route: Time/Frequency: Oral Topical Date to Start: Inhaled Injection

How to fill out child care medication authorization

How to fill out WV Early Childhood Child Care Medication Authorization

1. Obtain the WV Early Childhood Child Care Medication Authorization form from your child care provider or download it from the official website.
2. Fill in the child's name and date of birth at the top of the form.
3. Provide the name of the medication to be administered.
4. Indicate the dosage and frequency of the medication (e.g., how many times a day and specific times).
5. Specify the dates for which the medication should be administered, if applicable.
6. Include any specific instructions for administering the medication, including potential side effects to watch for.
7. Sign and date the form, and provide your contact information.
8. Ensure that the form is reviewed and signed by a licensed healthcare provider if required.
9. Submit the completed form to your child care provider before the child's first day of medication at the facility.

Who needs WV Early Childhood Child Care Medication Authorization?

1. Children who require medication to be administered during child care hours.
2. Children with chronic health conditions that necessitate medication management.
3. Any child whose caregiver wishes to provide over-the-counter medication while at the child care facility.

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What is WV Early Childhood Child Care Medication Authorization?

WV Early Childhood Child Care Medication Authorization is a formal document required for authorized administration of medication to children in licensed early childhood care facilities in West Virginia.

Who is required to file WV Early Childhood Child Care Medication Authorization?

The parent or guardian of the child who needs medication must file the WV Early Childhood Child Care Medication Authorization with the child care facility.

How to fill out WV Early Childhood Child Care Medication Authorization?

To fill out the WV Early Childhood Child Care Medication Authorization, parents or guardians should provide the child's details, medication information, dosage, administration schedule, and emergency contact information.

What is the purpose of WV Early Childhood Child Care Medication Authorization?

The purpose of the WV Early Childhood Child Care Medication Authorization is to ensure that children receive necessary medications safely and with proper oversight while in childcare settings.

What information must be reported on WV Early Childhood Child Care Medication Authorization?

Information that must be reported includes child's name, date of birth, medication name, dosage, administration frequency, method of administration, duration of the medication, and the parent's or guardian's contact information.