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ADAntihistamineAdministrationForm doc 2026

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  1. Click ‘Get Form’ to open the ADAntihistamineAdministrationForm in the editor.
  2. Begin by completing Part I, where a parent or guardian must provide their signature, contact information, and details about the medication, including whether it is a renewal or new prescription.
  3. Fill in the student’s name, date of birth, allergies, school name, and school year. Ensure that the first dose has been administered at home if it's a new medication.
  4. In Part II, a licensed healthcare provider must detail the allergic reactions and specify the medication's dosage and administration schedule. Use clear language without abbreviations.
  5. Finally, in Part III, ensure that a principal or registered nurse checks off all necessary items and provides their signature along with the date for compliance.

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Antihistamine medications are generally administered orally in a tablet dosage form. Intravenous (IV) and intramuscular (IM) administration are also possible, reserved chiefly for in-patient usage for the treatment of specific conditions.
They come in tablets, capsules, chewable tablets, and liquids. Many people buy them over the counter (OTC) at a store. You can also get them through a prescription from your doctor. Antihistamines are generally considered safe for most people.
How should this medicine be used? Diphenhydramine injection comes as a solution (liquid) to be injected intramuscularly (into a muscle) or intravenously (into a vein). Your dosing schedule will depend on your condition and on how you respond to treatment.

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Sample Forms | Medication Administration

These forms are provided as a resource to the RN instructor for use during the Medications Administration Training. Forms may be copied.

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