Global Games 2019 Medical Forms

Authorization for Prescription Medication

Diagnosis
(Type N/A, if not applicable)
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Medication & Dosage Prescribed
(Type N/A if not applicable)
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Instructions for Administering Prescription Medicine
 
(Medicine must be provided in a pharmacy container indicating the student's name as well as complete instructions for dispensing. Prescribing labels that state, "Take as Directed" will NOT be accepted.)
Parental Permission (to be signed & completed by Parent/Legal Guardian): 
I grant the Health Care Manager or his/her designated chaperone permission of our student's school to assist in the administration of each prescribed medication to be provided.
I hereby release and hold Nord Anglia Education and its affiliated companies and schools and their respective officers, employees, agents and represenatives harmless from any liability for administering these prescription medications.
Signature of Parent/Legal Guardian  *
clear
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