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PA Propel Schools Medicine Permission Form 2013 free printable template

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MEDICINE PERMISSION FORM School year: Student Name Grade Homeroom Name of Medication Diagnosis Dosage at (time/s) for (number) days Physician signature: I will take full responsibility for the prescribed
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How to fill out PA Propel Schools Medicine Permission Form

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How to fill out PA Propel Schools Medicine Permission Form

01
Obtain the PA Propel Schools Medicine Permission Form from the school's website or administrative office.
02
Fill in the student's personal information at the top of the form, including their name, date of birth, and grade.
03
Provide the parent's or guardian's contact information, including name, phone number, and email address.
04
List any medications the student is currently taking, including dosage and frequency.
05
Indicate any known allergies or medical conditions the student has that may be relevant.
06
Include emergency contact details in case of a medical situation during school hours.
07
Read and sign the parent/guardian consent section, authorizing the school to administer medication as per the provided instructions.
08
Submit the completed form to the school's health office or designated administrator.

Who needs PA Propel Schools Medicine Permission Form?

01
Any student enrolled in PA Propel Schools who requires medication during school hours needs the Medicine Permission Form.
02
Parents or guardians of students who need to administer prescription or over-the-counter medications while at school must complete this form.
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The PA Propel Schools Medicine Permission Form is a document that allows parents or guardians to authorize school personnel to administer medications to their child during school hours.
Parents or guardians of students who require medication during school hours must file the PA Propel Schools Medicine Permission Form.
To fill out the PA Propel Schools Medicine Permission Form, parents or guardians need to provide personal information about the student, details of the medication, dosage, administration times, and a signature indicating consent.
The purpose of the PA Propel Schools Medicine Permission Form is to ensure that students who need medication during school can receive it safely and legally with proper authorization from their parents or guardians.
The information that must be reported on the PA Propel Schools Medicine Permission Form includes the student's name, the name of the medication, dosage, administration schedule, and the parent's or guardian's contact information and signature.
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