LDSS-3635. Medication Log

Form LDSS-3635 (Medication Log) is a NYS Office of Children and Family Services form used to document and track medication intake and reactions for individuals in their care. The form requires the individual's name, date of birth, and/or medical record number, and is used to document any medication administered and any reactions that may occur. This form is typically filled out by a provider, such as a doctor or nurse, who is responsible for administering the medication.

The form consists of several sections, including a list of medications, the date the medication was administered, the dosage, and any reactions that may have occurred upon taking the medication. Additional sections may be included for medical history, allergies, and other medical information that may be pertinent to the individual. The form may also include instructions for proper administration of the medication, as well as any potential side effects or reactions that may occur.

Important fields in this form include the list of medications, the date of administration, the dosage, and any reactions that may have occurred. It is important to be accurate and thorough when completing the form so that the proper medication is administered and any reactions are accurately documented. It is also important to follow all instructions for proper medication administration and any additional instructions given by the provider.

This form would typically be used in a hospital or other medical facility where medications are administered. The purpose of the form is to document and track medication intake and reactions. This is important for ensuring proper administration of the medication and for the safety of the individual taking the medication. Additionally, the form can be used to identify any potential side effects or reactions to the medication.

Instructions for filling out the form include being accurate and thorough when documenting the medication, dosage, and reactions. Any additional information or instructions provided by the provider should be followed. In addition, any related forms or alternative forms that may exist for similar transactions or purposes should also be considered. These may include forms for consent to medical treatment, release of information, or other forms related to the individual's medical care.