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Click ‘Get Form’ to open it in the editor.
Begin by entering your child’s name in the designated field at the top of the form.
Review the understanding statement regarding topical applications. Ensure you are aware that certain conditions require a Medication Authorization Form signed by both you and your child's physician.
In the section provided, list the specific topical applications you permit staff to apply, ensuring they are appropriate for your child.
Indicate the date range for which this permission is granted, ensuring it does not exceed one year.
Finally, sign and date the form at the bottom to confirm your consent.
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