Get Medication Authorization Form - Blaine School District - Blaine Wednet

Completing the Medication Authorization Form accurately is essential for ensuring that students receive the necessary medications during school hours. This guide provides step-by-step instructions to assist you in filling out the form online effectively.

Follow the steps to complete the Medication Authorization Form.

1. Press the 'Get Form' button to obtain the form and open it for editing.
2. Begin by entering the current school year in the designated space provided at the top of the form.
3. Fill in the student's name, date of birth, grade, and school information in the respective fields.
4. Have the licensed health professional complete their section by entering their name, business phone number, and fax number.
5. For each medication, provide the name, dosage, and time(s) the medication should be given. Indicate the method of administration using the checkboxes (oral, injected, inhaled, or other).
6. Specify the start and end dates for the medication, ensuring the end date does not exceed the current school year.
7. In the diagnosis section, clearly state the reason for the medications indicated.
8. If applicable, indicate the necessary time between doses for PRN (as needed) medications.
9. Complete the information regarding inhalers, including whether the student is capable of self-administration and if they will carry the medication.
10. List possible side effects of the medication and provide emergency procedures in case of serious side effects.
11. The licensed health professional should sign and date the form to confirm authorization.
12. Next, the student's parent or guardian must complete their section, including giving consent for medication administration and self-administration if appropriate.
13. The parent/guardian should provide their name, signature, home phone number, work/cell phone number, and date.
14. Once all sections are completed, review the form for accuracy before saving changes, downloading, printing, or sharing the completed form.

Complete your Medication Authorization Form online today for a smooth medication administration process.