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5330 F1/page 1 of 3 PARENT REQUEST AND AUTHORIZATION TO ADMINISTER A PRESCRIBED MEDICATION/DRUG OR TREATMENT To the Parent THE FOLLOWING INFORMATION IS NECESSARY FOR ANY STUDENT TO USE PRESCRIBED MEDICATIONS OR TO RECEIVE TREATMENT IN SCHOOL. ALL SPACES MUST BE COMPLETED. NEOLA 2006 LICENSED PRESCRIBER S STATEMENT To the Prescriber The School District requires that all of the following information be provided before it will administer medication ....

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