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DORCHESTER SCHOOL DISTRICT TWO
20242025 REQUEST FOR MEDICATION TELEMONITORING OR MALADMINISTRATION
The following is to be completed by a physician/legal prescriber. One medication and/or dose per
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How to fill out self monitor self medicate

How to fill out self monitor self medicate
01
Follow the instructions provided by your healthcare provider on how and when to monitor and medicate yourself.
02
Keep track of your symptoms and vital signs regularly as per the recommended schedule.
03
Administer the prescribed medication according to the dosage instructions provided by your healthcare provider.
04
Stay in regular communication with your healthcare provider to report any changes in your condition or if you have any concerns about your self-monitoring and self-medicating routine.
Who needs self monitor self medicate?
01
Individuals with chronic illnesses who need to monitor their symptoms and medication regularly to manage their condition effectively.
02
Patients who have been instructed by their healthcare provider to self-monitor and self-medicate as part of their treatment plan.
03
Those who want to take control of their own health and wellness by actively participating in their medical care through self-monitoring and self-medication.
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What is self monitor self medicate?
Self monitor self medicate is a process where individuals keep track of their health parameters and administer medications to themselves as needed.
Who is required to file self monitor self medicate?
Individuals who need to manage their health conditions on a day-to-day basis are required to file self monitor self medicate forms.
How to fill out self monitor self medicate?
To fill out self monitor self medicate forms, individuals need to accurately record their health data and medication usage on a regular basis.
What is the purpose of self monitor self medicate?
The purpose of self monitor self medicate is to help individuals track their health progress and ensure they are taking necessary medications as prescribed.
What information must be reported on self monitor self medicate?
On self monitor self medicate forms, individuals must report details such as their vital signs, medication doses, and any symptoms experienced.
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