Routine Drug Administration Record printable pdf download

Routine Drug Administration Record

Name: _____________________________________________ Campsite: _______________________________

Troop No.: __________________ Date of birth: _______________ Classification: _______________________

Drug hypersensitivity: ____________________________________________________ Weight: _____________

Initial

Signature

Name

Position

______________________________________________________________________________________________________________

INSTRUCTIONS: Sheet is for reproduction as needed. It should be three-hole punched and kept in a binder during camp week. Use one

sheet for each camper with a prescription. Record all medicines brought to camp (up to FIVE medications per sheet). The medication,

dosage and dosage schedule should be copied from the prescription. Record dispensing times and days in the blocks provided for each

medication as they are dispensed. After camp, place sheet(s) inside the first aid log.

Routine Drug Administration Record