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REQUEST TO PROVIDE MEDICATION DURING SCHOOL HOURS: ACETAMINOPHEN AND IBUPROFEN HS0059 Rev. 12/10 Health Services Department Lincoln Public Schools IMPORTANT INFORMATION FOR PARENTS/GUARDIANS: Your
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Begin by gathering all necessary information and documents required for the request form. This may include your personal information, medical history, and prescription details.
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Carefully read the instructions provided on the request form. Ensure that you understand the purpose of the form and the information that needs to be provided.
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Fill in your personal information accurately, including your full name, address, contact number, and any other information requested.
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Provide details about your medical history, including any existing conditions, allergies, or medications you are currently taking. It is important to be thorough and honest in this section to ensure the safe and appropriate use of acetaminophen ibuprofen.
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Indicate the specific reason for your request for acetaminophen ibuprofen. This may include pain relief, fever reduction, or any other relevant medical condition that requires the use of these medications.
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Include the dosage and quantity of acetaminophen ibuprofen that you require. It is recommended to consult with a healthcare professional for the appropriate dosage and duration of use.
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If applicable, provide any additional information or special instructions that may be necessary for the request. This could include any specific brand preferences or delivery instructions.

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Individuals who are experiencing pain or fever and have been advised by a healthcare professional to take acetaminophen ibuprofen.
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Patients with specific medical conditions, such as arthritis or migraines, which acetaminophen ibuprofen can help manage.
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Anyone with a valid prescription for acetaminophen ibuprofen from their healthcare provider.
Note: It is important to consult with a healthcare professional before using any medication, including acetaminophen ibuprofen, to ensure its appropriate and safe usage.
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Acetaminophen ibuprofen request is submitted to the appropriate regulatory agency for approval.
Manufacturers or distributors of acetaminophen ibuprofen products are required to file the request.
The request must be filled out with detailed information about the product, including its ingredients, manufacturing process, and safety data.
The purpose of the request is to obtain authorization for the sale and distribution of acetaminophen ibuprofen products.
Information such as product formulation, safety data, manufacturing process, and labeling must be reported on the request.
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