• Authority to Administer Medication - Long Term

  • (This form is for long-term medication e.g. teething gel, puffers)

  • Medication Authority/action plans to be attached to this form – to be reviewed every 3 months

  • MM slash DD slash YYYY
    • Date
    • Reason given
    • Medication
    • Dosage
    • Time given
    • Given by
    • Dosage given
    • Checked by
    • Confirmed by parent
    • MM slash DD slash YYYY
    • MM slash DD slash YYYY
    • MM slash DD slash YYYY
    • MM slash DD slash YYYY
    • MM slash DD slash YYYY
    • MM slash DD slash YYYY
    • MM slash DD slash YYYY

Start typing and press Enter to search

X