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SavannahChatham County Public School SystemAUTHORIZATION FOR MALADMINISTRATION OF ASTHMA MEDICATION AND/OR BY A STUDENT AT A SCHOOL USE BLACK OR BLUE INK ONLYSTUDENT INFORMATION STUDENTS NAME:DATE
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How to fill out medication authorization allergic reactionanaphylaxis

01
Obtain the medication authorization form from the relevant healthcare provider or institution.
02
Read the instructions and information on the form carefully to ensure understanding of the purpose and requirements.
03
Provide personal and contact information accurately, including the patient's full name, date of birth, and contact details.
04
Clearly indicate the known allergies and specifically mention the allergic reaction/anaphylaxis that requires medication authorization.
05
If applicable, provide a detailed medical history, including any previous instances of allergic reactions or anaphylaxis.
06
Include the names and dosages of the medications that have been prescribed to manage allergic reactions or anaphylaxis.
07
If necessary, provide additional information or instructions for healthcare professionals who may need to administer the medication in case of an allergic reaction or anaphylaxis.
08
Review the completed form for any errors or missing information before submitting it.
09
Return the medication authorization form to the healthcare provider or institution as per their instructions.
10
Keep a copy of the completed form for personal records and ensure it is accessible during medical emergencies.

Who needs medication authorization allergic reactionanaphylaxis?

01
Individuals who have a history of allergic reactions or anaphylaxis and require medication as a precautionary measure or emergency treatment.
02
Individuals with known allergies that have the potential to cause severe allergic reactions or anaphylaxis.
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Medication authorization allergic reaction/anaphylaxis refers to the process of obtaining permission to administer medication in case of an allergic reaction or anaphylaxis.
Healthcare providers, caregivers, or individuals responsible for administering medication to a person with known allergies or history of anaphylaxis are required to file medication authorization.
To fill out medication authorization for allergic reaction/anaphylaxis, one needs to provide detailed information about the medication, the individual's allergies, symptoms of anaphylaxis, emergency contacts, and instructions for administration.
The purpose of medication authorization for allergic reaction/anaphylaxis is to ensure that necessary medication can be administered promptly and safely in case of an allergic reaction or anaphylaxis.
Information such as the individual's name, date of birth, allergies, prescribed medication, dosage, route of administration, known symptoms of anaphylaxis, emergency contact information, and any special instructions should be reported on medication authorization.
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