Get Authorization For Epinephrine/benadryl Administration By School Personnel Or Self-administration

Filling out the Authorization for epinephrine/benadryl administration form is essential for ensuring the safety of students who have known allergies. This guide offers clear and detailed instructions for completing the form online, making the process straightforward and accessible for all users.

Follow the steps to complete the authorization form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the first section, enter the student's name, date of birth, and grade. This information is crucial for identifying the student receiving the medication.
3. List any known allergies the student has in the designated field. This information helps school personnel manage potential allergic reactions effectively.
4. Specify the actions to take if the student ingests an allergen or is stung by an insect. Fill in the details regarding the statement provided.
5. Circle the desired dosage of the epinephrine auto-injector based on the student's needs. Options may include 0.15 mg or 0.3 mg. Make sure to identify which epinephrine auto-injector should be used.
6. Note any special instructions or side effects management in the appropriate sections. This ensures that all necessary information is communicated to school personnel.
7. Indicate whether the student is capable of self-administration of epinephrine by marking 'Yes' or 'No.' Note that if self-administration is authorized, prescriber training is required.
8. Ensure that an authorized prescriber signs and dates the authorization, including their contact information. This signature verifies that the documentation is legitimate.
9. The parent, legal guardian, or eligible student must provide their signature and date at the bottom of the form, acknowledging permission for medication administration.
10. After completing all sections, users can save changes, download, print, or share the form as necessary.

Complete the authorization form online to ensure timely and safe administration of necessary medications for your student.