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Attachment 11A Page 1 of 2Riverside University Health System Behavioral Health CHILD MEDICAL, MEDICATION, AND PRENATAL HISTORY CHILD NAME: AGE:DATE OF BIRTH:SS#: DATE: In order to provide the best
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How to fill out childs medical medication and

01
To fill out a child's medical medication form, follow these steps:
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Start by gathering all the necessary information about the child, including their full name, date of birth, gender, and contact information.
03
Next, collect details about the child's medical history, including any known allergies, existing medical conditions, and previous diagnoses.
04
Consult with the child's primary healthcare provider to obtain a comprehensive list of prescribed medications, including the dosage instructions and frequency of administration.
05
Ensure you have a clear understanding of each medication's purpose and potential side effects to accurately fill out the form.
06
Use the provided form or create a table with columns for medication name, dosage, frequency, and any special instructions.
07
Fill in the form by listing each medication, its prescribed dosage, and the designated frequency of administration.
08
Include any additional notes or instructions provided by the healthcare provider, such as requirements for medication storage or potential interactions with food or other drugs.
09
Double-check all the information filled in the form for accuracy and completeness.
10
If required, seek assistance from the child's healthcare provider or pharmacist to clarify any doubts or address any specific concerns.
11
Once the form is correctly filled out, sign and date it, and keep a copy for your records while providing the original to the appropriate authority or the child's school nurse.

Who needs childs medical medication and?

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Children who require medical treatment and medication on a regular basis need a child's medical medication form.
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This includes but is not limited to:
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- Children with chronic conditions, such as asthma, diabetes, epilepsy, or allergies, which require ongoing management.
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- Children recovering from surgical procedures or managing a post-injury treatment plan.
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- Children with developmental or behavioral disorders who require specialized medication.
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- Children attending daycares, schools, or camps that have policies in place to monitor and administer medication.
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- Children participating in sports or extracurricular activities that may require emergency medical attention.
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The child's medical medication form helps ensure that authorized individuals, such as healthcare providers and caregivers, have accurate information about the child's prescribed medications, enabling them to provide appropriate care and administer medications safely when needed.
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Child's medical medication refers to any prescribed drugs or treatments that are administered to a child for health-related issues, including over-the-counter medications as per a doctor's advice.
Parents or legal guardians of the child are typically required to file any necessary documentation regarding the child's medical medications with the appropriate authorities, such as schools or healthcare providers.
Filling out child's medical medication typically involves collecting all relevant information, such as the child's name, medication details, dosage, administration times, and any special instructions, and entering this information into the designated form provided by the healthcare provider or institution.
The purpose of child's medical medication documentation is to ensure that medical information is accurately recorded, tracked, and communicated to authorized personnel for the child's health and safety.
Information that must be reported includes the child's full name, date of birth, the names and dosages of medicines, prescribing doctor’s information, and any known allergies or reactions.
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