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DoDEA Form 05 SHSM H-3-2 Medication During School Day

DoDEA Form 05 SHSM H-3-2 Medication During School Day 2026

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The document outlines the procedures and requirements for administering medication to students during the school day within the Department of Defense Education Activity (DoDEA) schools. It includes sections for physician, parent/guardian, and school nurse to complete, detailing necessary health information, medication specifics, and consent for administration. The document emphasizes the importance of proper labeling and handling of medications, as well as the voluntary nature of providing information while noting potential consequences for non-compliance.

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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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What should you check before administering medication?

The six rights of safe. medication administration. * Ask the patient their first and last name * Does the order match the patient? Right medication 4. * Does the medication label match the order? * Does the strength and dosage match the order? time interval has passed. * Does the route match the order?

Can a school give you Tylenol?

All non-prescription and prescription medications are to be administered from the health office by the school nurse. This includes medicines such as eye drops, ointments, and antacids. Non-prescription medicines with the exception of Ibuprofen (Motrin) and Acetaminophen (Tylenol) will require a physician order.

What is the medication form for Fort Mill schools?

A medication permission form (M105) must be completed by the health care practitioner for each prescription medication to be given at school.

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Is ibuprofen legal or illegal?

IS IBUPROFEN BANNED IN THE US? No, it is openly available in the US and it is commonly advised under the OTC dose limit of FDA. The common brand name of ibuprofen is Advil.

What should you do if a client receives a new medication to be administered?

Provide information to patient about the medication before administering it. Answer questions regarding usage, dose, and special considerations. Give the patient an opportunity to ask questions. Include family members if appropriate.

What should the nurse do before administering any medications to the client?

The nurse should be aware of the patients allergies, as well as any history of any drug interactions. Additionally, nurses collect appropriate assessment data regarding the patients history, current status, and recent lab results to identify any contraindications for the patients to receive the prescribed medication.

What should a nurse check for before administering medication?

Assessment comes before medication administration. All medications require an assessment (review of lab values, pain, respiratory assessment, cardiac assessment, etc.) prior to medication administration to ensure the patient is receiving the correct medication for the correct reason.

DoDEA Form 05 SHSM H-3-2 Medication During School Day 2026

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