GA MJCCA Club J Authorization to Dispense Medication 2022-2025 free printable template
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CLUB J20222023
Authorization to Dispense MedicationPlease fill this form out for each medication that you want dispensed for your child. A new form will need to be completed every two weeks.
Child's
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How to fill out GA MJCCA Club J Authorization to Dispense Medication
01
Obtain the GA MJCCA Club J Authorization to Dispense Medication form from the program director or website.
02
Fill in the child's full name, date of birth, and parent or guardian contact information.
03
List the medications that need to be dispensed, including the name, dosage, frequency, and any specific instructions.
04
Include the prescribing physician's information, including their name and contact details.
05
Sign and date the authorization form, allowing the designated staff to administer the medication.
06
Provide any additional documentation required, such as a copy of the prescription, if necessary.
07
Submit the completed form to the program staff before the child attends the program.
Who needs GA MJCCA Club J Authorization to Dispense Medication?
01
Any child attending the GA MJCCA Club J who requires medication during program hours.
02
Parents or guardians of children who take regular medication for health conditions.
03
Children with allergies needing emergency medication, such as an EpiPen.
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What is GA MJCCA Club J Authorization to Dispense Medication?
GA MJCCA Club J Authorization to Dispense Medication is a form that allows designated individuals at the MJCCA Camp to administer medication to campers in compliance with state regulations.
Who is required to file GA MJCCA Club J Authorization to Dispense Medication?
Parents or guardians of campers who require medication during camp sessions are required to file the GA MJCCA Club J Authorization to Dispense Medication.
How to fill out GA MJCCA Club J Authorization to Dispense Medication?
To fill out the GA MJCCA Club J Authorization to Dispense Medication, parents must provide information about the camper, the medication, dosage, administration times, and any potential side effects, and sign the form.
What is the purpose of GA MJCCA Club J Authorization to Dispense Medication?
The purpose of the GA MJCCA Club J Authorization to Dispense Medication is to ensure that medications are administered safely and effectively to campers who require them during their time at camp.
What information must be reported on GA MJCCA Club J Authorization to Dispense Medication?
The information that must be reported includes the camper's name, the name of the medication, dosage instructions, the frequency of administration, any allergies, and emergency contact information.
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