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How to use or fill out medication administration form pdf with our platform
- Click ‘Get Form’ to open the medication administration form in the editor.
- Begin by entering today’s date at the top of the form. This helps keep track of when the request is made.
- Fill in the student’s name (Last, First, MI) and their school. This ensures that the medication is administered to the correct student.
- Provide the student’s date of birth in the specified format (Mo/Day/Yr) for accurate identification.
- Detail the student’s diagnosis and specify the medication being prescribed, including dosage and time of administration.
- Indicate the route of administration and any specific instructions related to how the medication should be given.
- Enter both start and end dates for when the medication should be administered, ensuring compliance with medical guidelines.
- If applicable, include the Diagnostic ICD-9 Code for Norfolk Public Schools only.
- Have a healthcare provider print their name, sign, and provide their contact number for verification purposes.
- Finally, ensure that a parent or legal guardian signs at the bottom, granting permission for school personnel to administer the medication as prescribed.
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