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Medication Permission Slip
ABC Academy, Inc. has my permission to administer medications which I bring from home for
_________________________________________________________________(child's name)
Each parent requesting that their child be given mediation will need to fill in the date and time of dosage and the name of medication on the medicine log each day they are requesting staff to administer medication to their child.
PLEASE NOTE:
Medication must be properly labeled:
* Prescription medication must have a pharmacy label giving the physicians name, child's name and strength of the medication and administration instructions
* All "over the counter" medications must have the child's name and administration instructions clearly written on the original container in which the medication was purchased.
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Parent's Signature _________________________________
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Date: ________________________
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Parent's Signature _________________________________
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Date: ________________________
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