Get Self Medication Form - E-gov Link

Filling out the Self Medication Form - E-Gov Link is a straightforward process designed to ensure proper medication administration for minors. This guide will walk you through each section of the form, providing clear instructions to help you complete it accurately.

Follow the steps to fill out the Self Medication Form effortlessly.

1. Click the ‘Get Form’ button to obtain the Self Medication Form and open it in the editor.
2. In the top portion, enter the child's name, date, and address. This section is to be completed by the caregiver.
3. The caregiver must sign the form, authorizing the medical director or representative to dispense medication, and provide the date and their address along with a phone number.
4. Fill in the authorization period by specifying the beginning and ending dates. Use the format: month, day, year.
5. In the lower section, physician details are required. The physician must provide the name of the medication, recommended dosage, and any additional comments.
6. The physician must also write their name, signature, and provide their address and phone number.
7. The final section is for G.I.A.C. staff to fill in the medical director’s name and signature.
8. After completing all sections, ensure to save any changes made on the form. You can then download, print, or share the completed form as needed.

Complete your Self Medication Form online and ensure proper care for your child.