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CLARKSVILLEMONTGOMERY COUNTY SCHOOL SYSTEM
NOTIFICATION OF PARENTADMINISTERED MEDICATION OUTSIDE OF SCHOOL HOURS
1.) Pursuant to TCA, Section 495415, subsection (g): and TN State Department of Health
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How to fill out notification of parentadministered medication

How to fill out notification of parent-administered medication:
01
Identify the student: Start by filling out the student's personal information at the top of the form. Include their full name, date of birth, grade level, and any other relevant information required.
02
Provide contact information: Include the contact details of the parent or guardian administering the medication. This typically includes their full name, phone number(s), and email address.
03
Specify the medication: List the name of the medication that will be administered to the student. Include any specific dosage instructions or other relevant information provided by the healthcare professional.
04
Indicate the administration schedule: State the frequency and timing of the medication administration. Include details such as the number of times per day and specific times when the medication should be given.
05
Describe the administration process: Write down step-by-step instructions on how the medication should be administered. Include information on dosage amounts, any necessary equipment, and any additional notes or precautions to be taken.
06
Mention any potential side effects: If there are any known side effects or adverse reactions to the medication, be sure to include them in the notification. This alerts school staff to be aware of any unusual symptoms the student may exhibit.
07
Obtain necessary signatures: The notification form may require signatures from both the parent or guardian and the school administration to verify that the information provided is accurate. Ensure that all required signatures are obtained before submitting the form.
Who needs notification of parent-administered medication?
01
School administration: The school administration needs to be informed about any medication being administered to students on campus. This ensures they are aware of any potential medical concerns and can provide appropriate support if needed.
02
Teachers and school staff: It is essential for teachers and other school staff members to be aware of any student requiring parent-administered medication. This enables them to provide any necessary assistance, supervision, or accommodations as needed.
03
School nurse or healthcare professionals: The school nurse or other healthcare professionals need to be aware of any medications being administered to students. This allows them to monitor the student's health and provide additional medical support if necessary.
04
Emergency responders: In case of a medical emergency, it is crucial for emergency responders to be aware of any medication the student is receiving. This information can help them make informed decisions and provide appropriate treatment.
It is important to note that specific notification requirements may vary depending on the school or educational institution. It is always advisable to consult with the school administration or healthcare professionals for any additional guidelines or specific instructions.
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What is notification of parentadministered medication?
Notification of parentadministered medication is a form that must be completed by parents or guardians to inform schools or childcare facilities about the medication their child will be administered while on the premises.
Who is required to file notification of parentadministered medication?
Parents or guardians are required to file notification of parentadministered medication for their child.
How to fill out notification of parentadministered medication?
The notification of parentadministered medication form can usually be obtained from the school or childcare facility and requires information such as the child's name, medication details, dosage, administration instructions, parent contact information, and physician's signature.
What is the purpose of notification of parentadministered medication?
The purpose of notification of parentadministered medication is to ensure schools or childcare facilities are aware of any medications being given to children to ensure proper administration and safety.
What information must be reported on notification of parentadministered medication?
Information such as the child's name, medication details, dosage, administration instructions, parent contact information, and physician's signature must be reported on the notification of parentadministered medication.
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