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Page 1 of 2POLK COUNTY SCHOOLS (PCS)MEDICATION AUTHORIZATION/REQUEST FORMHEALTHCARE PROVIDER only:Medication Strength/Dose Specific Directions please include exact amount to give, at what time and
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01
To fill out medication orders point by point, follow these steps:
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Start by writing the patient's full name, date of birth, and medical record number at the top of the medication order form.
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Specify the name of the medication prescribed, including the strength, dosage form, and any special instructions or restrictions.
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Indicate the prescribed dosage and frequency of administration, such as how many tablets or milliliters to take and how often.
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Provide clear instructions for how the medication should be taken, such as with or without food, at specific times of the day, or at bedtime.
06
Include the duration of the medication order, specifying the number of days or weeks the medication should be taken.
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Ensure proper documentation of any additional instructions or special considerations, such as storage requirements, repeated refills, or necessary laboratory monitoring.
08
Sign and date the medication order, ensuring your name and credentials are legible and easily identifiable.
09
If required, provide any necessary clinical justifications or rationale for the medication order.
10
Double-check the filled out medication order for accuracy and completeness before submitting it for review, verification, and processing.
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Submit the completed medication order to the appropriate healthcare provider or pharmacist for further action.
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Remember to follow your institution's policies, guidelines, and legal requirements when filling out medication orders.

Who needs medication orders - st?

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Medication orders are typically needed by:
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- Medical doctors, including primary care physicians, specialists, and surgeons, who prescribe medications for their patients' treatment.
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- Nurse practitioners and physician assistants who have prescriptive authority and prescribe medications within their scope of practice.
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- Pharmacists who provide medication therapy management and need medication orders to dispense medications.
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- Dentists and oral surgeons who prescribe drugs for oral health-related conditions or post-surgical care.
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- Veterinarians who prescribe medications for animal patients.
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- Other authorized healthcare practitioners who are legally allowed to prescribe medications based on their professional credentials and governing regulations.
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Medication orders refer to the formal instructions provided by a licensed healthcare professional for administering medications to patients.
Healthcare professionals such as doctors, nurse practitioners, and physician assistants are typically required to file medication orders.
Medication orders should be filled out by providing details such as patient information, medication name, dosage, frequency, and route of administration.
The purpose of medication orders is to ensure safe and effective administration of medications to patients, helping to prevent errors and overdoses.
Information such as patient name, medication name, dosage, administration route, frequency, prescribing provider, and date must be reported on medication orders.
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