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2004-347 DOC Participant Release and Waiver Form

2004-347 DOC Participant Release and Waiver Form-2026

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The document is an authorization form from the School District of Volusia County for administering prescription and non-prescription medication to students by school personnel. It outlines the requirements for medication administration, including the necessity for a doctor's authorization, proper labeling, and parental consent. The form must be completed with specific details about the student, medication, dosage, and potential side effects, and it emphasizes that medications must be delivered to the school by a parent or guardian.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the student's name in the designated field at the top of the form. This ensures that all medication is accurately associated with the correct student.
Next, provide the name of the doctor who has prescribed the medication. This is crucial for verification and compliance with school policies.
Fill in the name of the medication as well as specific dosage instructions, including exact times for administration. Be precise to avoid any confusion.
Indicate any special storage requirements for the medication, such as refrigeration, if necessary.
Complete the doctor's authorization section by having your physician sign and date it, ensuring their stamp is included for authenticity.
Finally, obtain a signature from a parent or guardian, along with their printed name and contact information. This confirms consent for administering medication during school hours.

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2004-347 DOC Participant Release and Waiver Form-2026

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