T.R | Title | User | Personal Name | Date | Lines |
---|
963.1 | Medical authorization form | YOSMTE::TOWERS_MI | | Wed Jun 12 1991 21:18 | 12 |
| I just finished a First Aid/CPR class as part of our Emergency Response
Team efforts and the instructor was a former Fireman and Emergency
Responder. He really pushed us to ensure we have proper forms for our
kids in case of an emergency and distributed a form used and accepted
in this state.
In order to get the wording correct I can send or Fax you a copy of
the form he gave us that is often used in this State (CA). I would
think it would be universal but you could check. If you want a copy
let me know. I will be in training Thursday but could Fax to you Friday.
Michelle
|
963.2 | I have the OFC recommended form for Ma. | HDLITE::FLEURY | | Wed Jun 12 1991 21:52 | 7 |
| RE: .0
I don't know where you are but, I have a copy of the form recommended
by the Office for Children here in Ma. If this would be of value, send
me your mail address.
Dan
|
963.3 | | GEMVAX::SANTOS | | Thu Jun 13 1991 11:32 | 6 |
| I also live in MA and would like to know the number for the Office for
children so I could get this form. Right now my baby sitter just has a
letter from me.
Della
|
963.4 | Consent form | WINDY::SHARON | Sharon Starkston | Thu Jun 13 1991 11:42 | 20 |
|
To Whom It May Concern:
As the parents of [name ] we authorize the bearer of
this letter to approve of medical treatment for our child if it is
required and we are unable to be reached. Our home telephone
number is xxx.xxx.xxxx and work numbers are xxx.xxx.xxxx (mom)
and xxx.xxx.xxxx/xxx.xxx.xxxx (dad). Our insurance is with xxxx
xxxxxxx and the group number is xxxxx. Coverage may be verified
by calling xxx.xxx.xxxx. The insured is [insured's name ]
employee number xxxxxx.
Our child's date of birth is [date of birth ]. He is not
allergic to any medications as far as we know. His pediatrician
is Dr. Xxxxxxxxx at [group name ], xxx.xxx.xxxx.
Signed
|
963.5 | Are they worth anything | HOTDOG::MESSIER | | Thu Jun 13 1991 17:04 | 9 |
| Do these forms really carry any weight? Will doctors and hospitals
really accept them? Is the caretaker liable if the parent differs
with the decisions that could be made? I realize the need but if
a lawyer gets a hold of one will he have a field day?
Questions, questions, questions, sounding like the four year old
already.
Dave
|
963.6 | Pediatrics at the hospital | BCSE::WEIER | Patty, DTN 381-0877 | Thu Jun 13 1991 17:34 | 5 |
| We got our forms - and were told to get our forms - from the pediatrics
department of the local hospital. That way too, if you give them THEIR
form, they'd have to take it, right??
Patty
|
963.7 | Update. | HDLITE::FLEURY | | Fri Jun 14 1991 09:09 | 20 |
| RE: a few
I checked the form and the wording listed a few notes back is almost
identical with the form I have. One thing I noticed this time though;
the OFC states that the form should be reviewed by the local hospital
to insure that it is sufficient. We are lucky in that all of the
children we care for see the same doctors and use the same hospital
facilities (when needed). Take a copy of the note (.-2 I think) and
bring it to your local hospital. They will indicate what type of
emergency services are covered by that sheet.
You should also sign a form giving permission to distribute medication
to your child. This includes over-the-counter medications as well.
Your provider should be recording ALL administrations of any
medication for your child. This is an OFC requirement too.
I'll post the forms for emergency treatment and medication here within
the next few days.
Dan
|
963.8 | Permission slip will work | JAWS::TRIPP | | Wed Jul 31 1991 10:34 | 21 |
| I'm late, but that's what happens with lots of time off,
RE: the question of whether Emergency personnell will honor these
forms, and overwhelming YES! (That's the EMT in me speaking)
As for my form I signed for daycare, I added to the form that he is to
be taken to a [specified] hospital, and included his medical record
number at the hospital, but then again he does have 5 or 6 volumes on
record up there. I also specified not only his general pedi's name but
his general surgeon, asthma specialist, and specified allergies to
medicines.
My understanding, at least from our provider, is that they are allowed
to administer ONLY prescription medicines, they must have the child's
name on the label, and they can NOT administer over the counter things
like tylenol etc.
Just a few thoughts.
Lyn
|
963.9 | OFC says parents can provide over the counters too. | HDLITE::FLEURY | | Thu Aug 01 1991 09:23 | 9 |
| RE: .8
There are specific forms (medication dispensing) which must be filled
out by the parent giving permission to administer medication. This
includes both perscription and over the counter. Without the form, no
medication of any kind should be given. Also, ALL medication must be
provided by the parent (this includes over the counter drugs as well.)
Dan
|
963.10 | | POWDML::SATOW | | Thu Aug 01 1991 13:09 | 10 |
| re: .9
> Also, ALL medication must be
> provided by the parent (this includes over the counter drugs as well.)
and left in its original container.
Clay
|