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AUTHORIZATION FOR SELFCARRY BY UCPS STUDENTS EMERGENCY MEDICATIONS Student\'s Name: ___ Birthdate: ___ Medication: ___ for ___Eligibility: Only students with diagnosed asthma, diabetes and/or severe

How to fill out medication-emergency self-carry authorization

How to fill out medication-emergency self-carry authorization

1. Obtain the medication-emergency self-carry authorization form from your school or healthcare provider.
2. Fill out the personal information section, including the student's name, address, and date of birth.
3. Provide details about the medication, including the name, dosage, and purpose.
4. Include the physician's information, including their name, contact number, and signature.
5. Add any necessary emergency contact information.
6. Ensure both the student and their parent or guardian sign the form.
7. Submit the completed form to the school administration or designated authority.

Who needs medication-emergency self-carry authorization?

1. Students who have a prescribed medication for emergencies, such as asthma inhalers or epinephrine auto-injectors.
2. Students with severe allergies or conditions that require immediate access to medication.
3. Parents and guardians of students who need to ensure their child can self-administer emergency medication.

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What is medication-emergency self-carry authorization?

Medication-emergency self-carry authorization is a legal provision that allows students to carry their emergency medications, such as asthma inhalers or epinephrine auto-injectors, with them at school or during school-sponsored activities.

Who is required to file medication-emergency self-carry authorization?

Students who require the use of emergency medications and wish to carry them on their person while at school or during school activities are required to file medication-emergency self-carry authorization.

How to fill out medication-emergency self-carry authorization?

To fill out medication-emergency self-carry authorization, a parent or guardian must complete the required form, providing details about the student, the medication, and any necessary instructions, and then submit it to the school administration.

What is the purpose of medication-emergency self-carry authorization?

The purpose of medication-emergency self-carry authorization is to ensure that students have immediate access to their emergency medications in case of an acute medical situation, promoting their safety and well-being.

What information must be reported on medication-emergency self-carry authorization?

The information that must be reported includes the student's name, the medication name, dosage, administration instructions, and contact information for the parent or guardian.