Get Medication Authorization Form - The Evergreen State College

Filling out the Medication Authorization Form for The Evergreen State College is an essential process to ensure that your child receives medication safely. This guide will provide you with clear, step-by-step instructions to complete the form accurately and efficiently.

Follow the steps to complete the Medication Authorization Form online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the child’s name in the designated field to specify who the medication is for.
3. Indicate the health problem affecting the child to provide context for the medication.
4. Enter the name of the medication prescribed for the child.
5. Specify the amount to be given per dose, ensuring it aligns with the doctor's instructions.
6. Detail the frequency of dosage—how often the medication should be administered (e.g., daily, twice a day).
7. List the times the medication is usually given at home for reference.
8. Indicate the method of administration at The Evergreen State College Campus Children’s Center.
9. Fill in the amount per dose and the specific time to be given at the center.
10. Provide the dates when the medication should begin and when it should be completed.
11. Sign the authorization section to give permission for the center to administer the medication, and agree to take home any leftover medication afterward.
12. Finally, include the date of your signature to confirm your acknowledgment.
13. Ensure the record of administration section is left blank for the designated staff member to fill out, which records the date, time, and initials of each dose administered.

Complete the Medication Authorization Form online today to ensure your child's health needs are met effectively.