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Urbana School District #116 1101 E. University Avenue, Suite B, Urbana IL 61802 2173843600 USD#116 MEDICATION AUTHORIZATION / RELEASE FORM To be completed by Parent/Guardian: Students Name ___ Birth
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How to fill out usd116 medication authorization

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How to fill out usd116 medication authorization

01
Obtain the medication authorization form from USD116 school administration or website.
02
Fill out the student's name, date of birth, grade, and school information.
03
Provide the name of the medication, dosage, frequency, and time of administration.
04
Include the prescribing physician's name and contact information.
05
Indicate any special instructions or considerations.
06
Sign and date the form, acknowledging consent for medication administration.
07
Submit the completed form to the school nurse or designated staff member.

Who needs usd116 medication authorization?

01
Any student who requires medication to be administered during school hours.
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USD116 medication authorization is a form that allows individuals to authorize the use of certain medications.
Any individual who wants to authorize the use of specific medications is required to file the USD116 medication authorization.
To fill out the USD116 medication authorization, you need to provide your personal information, details of the medication being authorized, and sign the form before submitting it.
The purpose of USD116 medication authorization is to ensure that individuals give their consent for the use of specific medications.
The USD116 medication authorization form must include personal information of the individual, details of the medication being authorized, and the signature of the individual.
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