Common Contracts
1 similar Parental Agreement for School to Administer Prescribed Medicine contracts
PARENTAL AGREEMENT FOR SCHOOL TO ADMINISTER PRESCRIBED MEDICINEParental Agreement for School to Administer Prescribed Medicine • May 2nd, 2019
DATE CHILD’s NAME CLASS MEDICAL CONDITION / ILLNESS NAME OF MEDICINE EXPIRY DATE DOSAGE REQUIRED TO BE GIVEN AT WHAT TIME ON WHICH DAYS (please circle) MON TUE WED THUR FRI TIME OF PREVIOUS DOSAGE (if taken) ARE THERE ANY POSSIBLE SIDE EFFECTS? CAN YOUR CHILD SELF-ADMINISTER? PROCEDURE TO TAKE IN AN EMERGENCY CONTACT DETAILS Name: Daytime contact no.: Relationship to child:
