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MEDICATION PERMISSION FORM
Prescription medication must show the date, students name, name of medication, dosage directions, licensed prescribers name, and rx number (if there is one).
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Medication Prior Authorization or Exceptions request form
Medication Prior Authorization / Exceptions. Request Form. Fax: (866) 236-8531. To ensure a timely response, please fill out form COMPLETELY and LEGIBLY. An
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Medication Authorization Form
Each time medication is administered to a child, a staff person shall enter the date, time of day, medication, medication dosage, method of administration, and
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