THE SCHOOL BOARD OF SARASOTA, COUNTY AND SARASOTA COUNTY HEALTH DEPARTMENT SCHOOL HEALTH SERVICES MEDICATION/TREATMENT VARIANCE D INSTRUCTIONS: Fill in form completely and send to Sarasota County Health Department School Health Nursing 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the student's name (last name first) and their date of birth, followed by the date and time of the variance.
3. Fill in the name of the school where the incident occurred.
4. Provide details about the prescribed medication or treatment, including dosage, route, and time as specified on the Medication/Treatment Authorization Form.
5. Indicate who administered the medication/treatment along with their position (e.g., Health Aide, RN).
6. Select any applicable errors/variances from the provided list by checking the corresponding boxes.
7. Document the time and a description of what happened in the designated area.
8. Mark the location where the variance took place.
9. Describe actions taken and times; include all persons contacted regarding this incident.
10. List all individuals notified about the variance along with dates and times of notification.
11. Print your name as the person completing this report, sign it, and enter today's date.
12. Leave 'Reviewed By' line blank before sending via interoffice mail or FAX to School Health Supervisor at the Landings.

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