Get Medication Form 2014-15-5 - Brcs137bborgb

Filling out the Medication Form 2014-15-5 is a crucial step in ensuring that students receive the appropriate medical care while at school. This guide provides a comprehensive, step-by-step approach to assist users in completing the form online.

Follow the steps to accurately complete the Medication Form.

1. Click the 'Get Form' button to obtain the form and open it in your preferred online editor.
2. Begin by entering the student's personal information. Fill in the student's name, address, home phone number, school, date of birth, emergency contact phone number, grade, and teacher in the designated sections.
3. The next section must be completed by the student's health care provider. They should print their name, office address, phone numbers, and emergency contact number. Next, include the name of the medication, its purpose, dosage, and frequency of administration.
4. Specify the time the medication should be administered or the circumstances under which it should be given. Also, include prescription date, order date, and discontinuation date along with the diagnosis requiring the medication.
5. Indicate whether it is necessary for this medication to be administered during the school day by selecting 'Yes' or 'No'. Provide details on any expected side effects and the time interval for re-evaluation.
6. Document any other medications the student is currently receiving. The prescribing health care provider must sign the form, indicating their approval for the medication administration.
7. In the section for inhalers or epinephrine auto-injectors, the provider must certify that the student understands how to use the medication and confirm their ability to self-administer.
8. Parents or guardians must provide their authorization for the student to carry and self-administer inhalers or epinephrine auto-injectors by initialing the appropriate section.
9. Finally, parents or guardians should print their name, contact information, and sign the form, confirming their agreement to be responsible for administering medication if necessary.
10. Once all sections are completed, save the changes, download the completed form, print it, or share it as needed.

Complete your Medication Form online today to ensure your child's medical needs are met at school.