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Medicines Needed at School or Child Care

 

Child's name ____________________________________________________ 

Diagnosis _______________________________________________________ 

Medicine name ___________________________________________________  

Dosage __________________________________________________________

Potential side effects _______________________________________________


When to give medicine 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 _________________________________
Published by McKesson Provider Technologies.
Last modified: 2006-05-02
Last reviewed: 2006-02-06
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
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