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20232024 PHYSICIAN/PARENT CERTIFICATION FOR STUDENTS SELFADMINISTRATION OF MEDICATION CERTIFICATION TO BE COMPLETED BY PHYSICIAN STUDENT NAME: DIAGNOSIS: NAME OF MEDICATION: DOSAGE: TIME AND CIRCUMSTANCES
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How to fill out students self-administration of medication

01
Ensure the student has a written request from their parent or guardian to self-administer medication.
02
Obtain written authorization from a healthcare provider for the student to self-administer medication.
03
Educate the student on when and how to take the medication correctly.
04
Provide a secure location for the student to store their medication.
05
Document each time the student self-administers medication and monitor for any adverse reactions.
06
Regularly review and update the student's self-administration plan as needed.

Who needs students self-administration of medication?

01
Students who have medical conditions that require regular medication throughout the day.
02
Students who are able to responsibly self-administer medication under adult supervision.
03
Students who have written authorization from a healthcare provider and their parent or guardian to self-administer medication.
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Students self-administration of medication refers to the process where students are allowed to manage and take their own medications during school hours under specific guidelines.
Typically, the parents or guardians of the student are required to file the necessary documents for self-administration of medication, often in collaboration with school nurses and administration.
To fill out the form for students self-administration of medication, one must provide information including the student's name, the medication details, dosage, administration times, and any potential side effects.
The purpose of students self-administration of medication is to empower students to take responsibility for their own health needs while ensuring they can manage their medications safely at school.
Information that must be reported includes the student's health condition, type of medication, dosage instructions, emergency procedures, and a signed consent from the parent or guardian.
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