Get Medication Authorization Form - Ymca Dc - Ymcadc

Filling out the Medication Authorization Form is an essential step in ensuring that your child receives the proper medications while in care. This guide will walk you through each section of the form, providing clear and supportive instructions to help you complete it accurately and efficiently.

Follow the steps to fill out the Medication Authorization Form accurately.

1. To begin, click the ‘Get Form’ button to access the Medication Authorization Form, then open it in your chosen editor.
2. In Section A, complete the information for your child. Write the child's name, and provide your name as the parent or guardian who grants permission to administer medication.
3. Indicate the name of the child care provider who has permission to give the medication.
4. Fill out the medication name, dosage, and the specific times the medication should be administered.
5. Include any special instructions regarding the medication, if applicable.
6. Specify the effective dates for the authorization, including a start date and an end date for when the medication can be administered.
7. Sign and date the form, confirming your authorization as the parent or guardian.
8. If the authorization is for a long-term medication exceeding 10 working days, proceed to Section B which needs to be completed by the child’s physician.
9. In Section B, the physician must certify the necessity of the medication for your child. Make sure they write their name, along with the child's name, medication details, dosage, and any special instructions.
10. The physician should also provide their signature, date, and phone number for verification.
11. If applicable, for non-prescription medications, authorize the use by listing the product name and any known adverse reactions in the relevant section.
12. Ensure that all over-the-counter products are in their original containers and meet the specified criteria. Indicate the effective dates for their usage.
13. Finally, review all completed sections for accuracy before saving, downloading, printing, or sharing the form as needed.

Complete your form online today to ensure your child’s health and safety in care.