Common Contracts
1 similar Parental Agreement for School to Administer Medicine contracts
PARENTAL AGREEMENT FOR SCHOOL TO ADMINISTER MEDICINE on Residential visit FORM CParental Agreement for School to Administer Medicine • June 20th, 2014
Name of child : Date of Birth Medical condition or illness : Name/type of medicine (as described on the container)storage : Date dispensed : Expiry date : Dosage & method : Date & time of last dosage the child was given : Date of first dosage to be given on trip: Date of last dosage to be given on trip: Time(s) of dosage(s) : Possible side effects : Child to self-administer : Yes / No (delete as appropriate) Procedures to take in emergency : Name & surgery/tel no of GP : Has the medicine has been administered without adverse effect to the child in the past and has the parent/carer certified this is the case Yes / No (delete as appropriate)
