Authorization to Administer Medication - Child Care Centers, DCF-F-CFS0059 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out Section A, which includes the Facility and Child Information. Enter the Child Care Center Name, Child's Name, and Birthdate.
3. Proceed to Section B for Medication Information. Input the medication name, dosage, administration times, and period. Ensure that the medication is in its original container with proper labeling.
4. If applicable, indicate whether a physician consultation is required for over-the-counter medications. Provide any additional information or special instructions as needed.
5. In Section C, have the parent or guardian sign and date the authorization to administer medication.
6. For certified child care providers, complete the Documentation of Medication Administration section by logging each instance of medication given, including date, time, dosage, and signature of the administrator.

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