Parental Agreements with Child Care Facility Note: Do not leave any field blank nor use N/A. Please answer all prompts as all apply in one way or another.June 15th, 2017
FiledJune 15th, 2017Before any medication is dispensed to my child, I will provide a written authorization, which includes: date; name of child; name of medication; prescription number; if any; dosages; date and time of day medication is to be given. Medicine will be in the original container with my child's name marked on it.