Follow the steps to fill out the form correctly

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the student’s name in the designated field. Ensure it is spelled correctly to avoid any confusion.
3. In the next fields, provide the student’s date of birth, school name, teacher’s name, and grade.
4. Proceed to the section marked 'TO BE COMPLETED BY THE PHYSICIAN OR AUTHORIZED PRESCRIBER.' Fill in the name of the prescribed medication.
5. Optionally, specify the reason for medication in the appropriate field if necessary.
6. Indicate the form of medication or treatment being administered (e.g., tablet, liquid, inhaler, injection, nebulizer, or other) by selecting the relevant option.
7. Complete the dose and time section by detailing when the medication should be given at school.
8. If there are any restrictions or important side effects, indicate that in the provided area, as 'None anticipated' or 'Yes.' If yes, provide a description.
9. If the medication has special storage requirements, specify them in the special storage requirements section.
10. The physician must then fill in their name, address, city, state, and zip code. Don’t forget to include their phone number.
11. The date of signing and the physician’s signature must be added to finalize this section.
12. Next, the parent or guardian section must be completed. State the name of the child receiving the medication, sign, and indicate the relationship to the child.
13. Lastly, the school office will complete their section by noting the date the form was received and the date medication was received.
14. After completing all sections, save your changes, and ensure to either download, print, or share the form as needed.

Complete your MI Wayne-Westland Community Schools Medication Authorization Form online today!