Story Book Forms
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Form to administer medication
The attached form must be filled out before we can administer any medication. Caregivers should fill out the top portion and the authorization near the bottom. The prescribing physician must sign in the box labeled "For Prescription Medication". If a doctor's signature is not on the form we will not be able to administer the medication until it is signed. Your child's medication will be stored in a secure lock box.