Daily Medication Administration Schedule For School Year

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DAILY MEDICATION ADMINISTRATION FOR SCHOOL YEAR
STUDENT
TEACHER
Medication/Dose/Time Month
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Aug
Sept
Oct
Medication/Dose/Time Month
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Nov
Dec
Jan
Medication/Dose/Time Month
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Feb
March
April
Medication/Dose/Time Month
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
May
June
July
CODES
SIGNATURE & INITIAL of those AUTHORIZED TO ADMINISTER MEDICATIONS
Medication given
Initial
Student Absent A
No Show
NS
Late
L
Field Trip
FT
Medication Out
MO
MEDICATION DATE/NAME/AMOUNT BROUGHT IN
DATE
NAME OF MEDICATION
AMOUNT
DATE
NAME OF MEDICATION
AMOUNT
DATE
NAME OF MEDICATION
AMOUNT
MEDICATION NAME
DATE DISCARDED
HOW DISCARDED
TWO SIGNATURES

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