Get 5330.04 F3 Staff Acknowledgement Of Training For The Administration Of (naloxone

Filling out the 5330.04 F3 Staff Acknowledgement Of Training For The Administration Of Naloxone is an essential step for staff designated to administer naloxone in emergency situations. This guide will walk you through each section of the form to ensure you complete it accurately and efficiently.

Follow the steps to fill out the form correctly.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. Locate the section identifying the school year. Fill in the appropriate school year for which you have been trained to administer naloxone.
3. In the designated space, add the name and sign off of the Superintendent’s designee (building administrator) along with their title and the date of signing.
4. Next, have the school nurse provide their signature and date, confirming their role in your training.
5. Review the list on the form where the school nurse verifies the training components. Ensure all items are checked to confirm you have received training on signs and symptoms of an overdose, written procedures, skill demonstrations, medical risks, and a chance to ask questions.
6. As an acknowledgment of your understanding and capability to perform the procedure, provide your signature, title, and the date trained.
7. If there are additional staff members who have undergone similar training, repeat the signature and training documentation steps for each, ensuring all necessary personnel are accounted for.
8. Once all signatures and information are completed, save changes, then use options to download, print, or share the form as needed.

Complete the 5330.04 F3 Staff Acknowledgement Of Training For The Administration Of Naloxone online today to ensure your readiness in emergency situations.