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Medicine Authorization Form

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Permission to Administer Medication

From time to time, your child may need pain reducing or antihistamine medication while at school. We must have your written permission to administer such medication. By completing and submitting this form you hereby give Temple Emanu-El Early Childhood Education Center permission to administer Benadryl, Tylenol, Motrin, or any preferred pain reducer to your child when necessary. I understand I will be contacted by the Early Childhood Education Center first, before administering medication to alert me of the problem.

Your child will not be allowed to remain at school if a fever occurs with the pain. ECEC will not administer fever reducing medicine if fever is present.

To administer physician prescribed medications or medical treatments to children attending TE ECEC, we must have written permission from the parents.

By completing and submitting this form you grant us permission to administer the following medication to your child.

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Name of parent/guardian:
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Logo     8500 Hillcrest Road          Tel. 214.706.0000
     Dallas, Texas 75225          Fax 214.706.0025

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