Medication Authorization/Modification Form
Please note the following requirements, if not followed, will result in medication not given.
- Medication MUST be in its original container.
- Medication must bear a printed label clearly stating the name of the child to whom the medication has been, prescribed.
- All information above MUST be completed.
- Medication Authorization/Modification Form to be updated, by parents, as changes occur
or at least every three months.