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How to use or fill out DoDEA Form 05 SHSM H-3-2 Medication During School Day
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the student's name, date of birth, and grade in the designated fields at the top of the form.
- In the section for medication details, provide the diagnosis and indication for medication administration. Fill in the medication name, dosage, time, route, and duration as prescribed by the physician.
- List any possible side effects and precautions or restrictions related to the medication in their respective fields.
- Ensure that a physician or primary care manager signs and stamps the form. Include their clinic phone number for verification.
- As a sponsor/parent/guardian, sign and date the form to give permission for your dependent to receive medication at school. Make sure to understand your responsibilities regarding medication supply and pick-up.
- Complete any additional notes required by the school nurse upon receiving the medication at school.
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See more DoDEA Form 05 SHSM H-3-2 Medication During School Day versions
| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2017 | 4.2 Satisfied (36 Votes) |
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