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AUTHORIZATION FOR MALADMINISTRATION OF MEDICATION AT SCHOOL STUDENT ___BIRTHDATE ___SCHOOL ___ TEACHER ___ GRADE ___SCHOOL YEAR ___ THIS SECTION TO BE COMPLETED BY STUDENTS LICENSED HEALTH CARE PROVIDER
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01
Fill out the student's information section at the top of the form including their name, date of birth, grade, and school.
02
Provide details of the medication to be administered including the name of the medication, dosage, time to be given, and any special instructions.
03
The prescriber section should be completed by the healthcare provider prescribing the medication including their name, title, phone number, and signature.
04
The parent or guardian should fill out their section which includes their name, relationship to the student, phone number, and signature.
05
Review the completed form to ensure all sections are filled out accurately before submitting it to the school.

Who needs school-medication-prescriber-parent-authorizationpdf?

01
Students who require medication to be administered at school.
02
Parents or guardians of students who need medication to be given during school hours.
03
Healthcare providers prescribing medication for students to be taken at school.
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It is a form that authorizes the administration of medication to a student by school staff.
Parents or legal guardians of the student.
The form must be completed with the student's information, medication details, prescriber details, and parent or guardian signature.
The purpose is to ensure that school staff have authorization to administer medication to a student if needed during school hours.
Student information, medication details, prescriber information, and parent or guardian authorization.
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