Get the free STUDENT MEDICATION AUTHORIZATION FORM Newly Revised 7/2020
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STUDENT MEDICATION AUTHORIZATION FORM Newly Revised 7/2020 (This side to be completed by physician or licensed provider) TO:Marquardt School District 15 1860 Glen Ellyn Rd. Glendale Heights, IL 60139The
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How to fill out student medication authorization form
How to fill out student medication authorization form
01
Obtain a student medication authorization form from your school or educational institution.
02
Fill out the top section of the form with the student's personal information, including their name, date of birth, and contact information.
03
Specify the details of the medication that needs to be administered, such as the name of the medication, dosage, and frequency.
04
If necessary, provide additional information about the medication, such as any potential side effects or special instructions for administration.
05
Indicate the date range for which the authorization is valid, usually the duration of the school year.
06
Sign and date the form to certify that you are the parent or guardian authorizing the medication administration.
07
Return the completed form to the appropriate school staff, such as the school nurse or principal.
Who needs student medication authorization form?
01
Any student who requires medication administration during school hours or while participating in school-related activities needs a student medication authorization form. This includes students with chronic illnesses, disabilities, allergies, or any other condition that necessitates regular medication.
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What is student medication authorization form?
The student medication authorization form is a document that grants permission for a student to receive medication during school hours and outlines the details of the medication required.
Who is required to file student medication authorization form?
Parents or guardians of students who require medication to be administered during school hours are required to file the student medication authorization form.
How to fill out student medication authorization form?
To fill out the student medication authorization form, complete all required fields including the student’s name, medication details, administration times, dosage, and any relevant medical information, then obtain the necessary signatures from a healthcare provider.
What is the purpose of student medication authorization form?
The purpose of the student medication authorization form is to ensure that school officials have the necessary permission and information to safely administer medication to students during school hours.
What information must be reported on student medication authorization form?
The form must include the student's name, date of birth, name of the medication, dosage, administration times, possible side effects, and signatures from both a parent/guardian and a licensed medical provider.
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