CUSD Health Manual and Forms Chandler Unified School District CONSENT FOR GIVING PRESCRIPTION AND NON-PRESCRIPTION MEDICATION AT SCHOOL FORM Please check here if NON-prescription Student Name Birthdate For prescription medication the healthcare provider must complete the information required below. Medication must be delivered to school in the original container with the label intact and is to be given in the following manner Name of Medication S.
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How to fill out the Medication Consent Form - Chandler Unified School District online
Filling out the Medication Consent Form for the Chandler Unified School District is an essential process to ensure that your child receives the appropriate medication while at school. This guide will provide straightforward instructions to help you complete the form accurately and efficiently.
Follow the steps to effectively complete the form
- Click ‘Get Form’ button to access the Medication Consent Form and open it in the editor.
- Enter the student’s name in the designated field to identify the individual for whom the medication is intended.
- Input the birthdate of the student to match the consent with the correct individual.
- For prescription medication, ensure the healthcare provider completes the required sections. This includes entering the name of the medication in the corresponding field.
- Specify the strength of the medication, including any particular measurements or concentrations as provided by the prescription.
- Detail the amount of medication to be given during school hours to avoid any confusion.
- Indicate the time at which the medication will be administered at school to ensure proper timing and adherence.
- Select the route of administration, such as by mouth or any other method as specified.
- Provide any additional comments or instructions that may assist school personnel in the administration of the medication.
- Clarify the reason for the medication in the stipulated section to provide context for its use.
- Input the date when the medication is to be discontinued, ensuring that there is a clear endpoint for the administration.
- Have the healthcare provider's name printed along with their phone number to facilitate contact if necessary.
- Ensure the healthcare provider signs and dates the form to validate the information provided.
- Authorize the designated person by signing the Parent/Guardian Signature section, following this with the date.
- Provide the teacher's name and room number to help school staff administer the medication correctly.
- Include both the home phone number and work phone number of the parent/guardian to maintain contact.
- Upon completing the form, save the changes, and consider downloading, printing, or sharing the form as needed.
Complete your Medication Consent Form online today to ensure your child's health needs are met at school.
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