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Get Va Fairfax County Public Schools Ss/se-64 2015
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How to fill out the VA Fairfax County Public Schools SS/SE-64 online
Filling out the VA Fairfax County Public Schools SS/SE-64 form online is a crucial step in ensuring that your child receives the appropriate medical attention during school hours. This guide will provide you with a comprehensive and user-friendly approach to completing this important document.
Follow the steps to successfully complete the VA Fairfax County Public Schools SS/SE-64 form.
- Click 'Get Form' button to obtain the form and open it in the editor where you can fill out the information online.
- In Part I, the parent or guardian must complete the authorization section. Provide the student’s name (last, first, middle), date of birth, school name, school year, and grade.
- Authorize Fairfax County Public Schools and associated personnel to administer epinephrine injections as directed by the physician by checking the consent box in this section.
- Sign and date the authorization to release and hold harmless clauses. Include your daytime telephone number to facilitate communication if needed.
- In Part II, the physician must complete their section. They will provide necessary medical directives regarding administration of epinephrine, including route of exposure and specific allergens. Ensure this part is thoroughly filled out.
- Ensure the physician signs and dates the form. If necessary, they should use their stationery to include details required in Part II.
- In Part III, the principal or principal designee will verify that Parts I and II are completed and that medication is properly labeled. This section must also be signed and dated.
- Review the entire form for accuracy. Once completed, you can save changes, download, print, or share the finalized form as needed to maintain records.
Complete the VA Fairfax County Public Schools SS/SE-64 form online to ensure your child's health needs are addressed effectively.
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This medicine is injected under the skin or into the muscle of your outer thigh only. Do not inject this medicine into a vein, into the muscle of your buttocks, or into your fingers, toes, hands, or feet. To do so, may increase the chance of having serious side effects.
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