Children & Adolescents Clinic

 Home Parent's Guide

Clinical Reference Systems: Pediatric Advisor 10.0

Medications Needed at School or Day Care

 

Child's name ____________________________________________________ 

Diagnosis _______________________________________________________ 

Medication name _________________________________________________  

Dosage __________________________________________________________

When to give medication at school or day care: 

_________________________________________________________________ 

_________________________________________________________________ 

Thank you.  Please call if you have any questions.  


Physician's name ________________________________________________

Physician's signature _________________________ Date ____________

Physician's phone number _________________________________

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