Medication AgreementMedication Agreement • February 22nd, 2019
Contract Type FiledFebruary 22nd, 2019This information is confidential and will be available only to relevant staff and emergency medical personnel. The agreement section must be completed by a medical practitioner (GP or specialist), nurse practitioner, or pharmacist. Authorisation/Release must be completed by the parent or legal guardian, or the adult student. The authorisation/release and agreement sections must be completed 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