AUTHORIZATION TO ADMINISTER MEDICATION CHILD CARE CENTERS – DOCUMENTATION OF MEDICATION ADMINISTRATION CERTIFIED CHILD CARE PROVIDERS – Instructions: This section is to be completed only by certified child care providers to document the actual administration of the medication. Lines should not be skipped. Signature / Initials of Person Who Administered the Date Administered Time Administered Dosage Medication
AUTHORIZATION TO ADMINISTER MEDICATION – CHILD CARE CENTERS DOCUMENTATION OF MEDICATION ADMINISTRATION – CERTIFIED CHILD CARE PROVIDERS Instructions: This section is to be completed only by certified child care providers to document the actual administration of the medication. Lines should not be skipped. Date Administered Time Administered Dosage Signature / Initials of Person Who Administered the Medication
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