Medication AgreementMedication Agreement • May 14th, 2020
Contract Type FiledMay 14th, 2020This information is confidential and will be available only to relevant staff and emergency medical personnel. The agreement section must be signed by a medical practitioner (GP or specialist), nurse practitioner, or pharmacist. Authorisation/Release must be signed by the parent or legal guardian, or the adult student. The authorisation/release and agreement sections must be signed for the medication to be administered in an education or care setting. This is a single medication sheet; use a separate form for each medication. All sections of the form must be completed.Medication Agreements that are modified, overwritten or illegible will NOTbe accepted. UR / Client number:(if relevant) Name: Address: DOB: Fill in or attach the patient label