Form LIC 9221. Parent Consent For Administration Of Medications And Medication Chart - California

Form LIC 9221 is used in California by child care facilities to obtain parental consent for the administration of medications to children under their care. This form is completed by parents or guardians when they authorize the facility staff to administer medications to their child.

The form consists of sections that request information about the child, medication details, and parental consent. Important fields include the child's name, medication name, dosage instructions, any potential side effects or allergies, and the parent or guardian's signature to indicate their consent. It is crucial to accurately document all necessary information and obtain proper parental consent to ensure the safe administration of medications within child care facilities.

An application example of this form would involve a child care facility providing Form LIC 9221 to parents or guardians when there is a need to administer medications to a child. The parent or guardian would complete the form by providing the child's information, details about the medication, and their consent through signature. By obtaining proper consent and maintaining accurate medication records, child care facilities can ensure the well-being and safety of children under their care.