LDSS-7003. Verbal Medication Consent Form and Log of Administration

Form LDSS-7003, Verbal Medication Consent Form and Log of Administration is a New York State Office of Children and Family Services form used to document parents' consent for the administration of medication to their children while in foster care.

The form consists of two sections: the Verbal Medication Consent Form and the Log of Administration. The Verbal Medication Consent Form includes the child's name, date of birth, and parent/guardian's name; the name of the medication; the dosage; the date of administration; and the signature of the parent/guardian. The Log of Administration includes the same information, but it also includes the name of the person who administered the medication, the reason for administration, and the date of the parent/guardian's consent. Both sections must be completed for each instance of medication administration.

Important fields in this form include the name of the medication, the dosage, and the date of administration. This information is necessary to ensure accuracy and consistency in the administration of the medication. Additionally, the parent/guardian's signature is required for consent. The signature serves as an indication that the parent/guardian understands and agrees to the administration of the medication.

This form is typically used when a child is taking medication while in foster care. The parent/guardian must provide consent for the medication to be administered and the form is used to document this consent. The form is also used to keep track of the medication administration, including the date of administration and the name of the person who administered the medication.

Specific instructions for filling out the form include ensuring that all information is accurate and up to date, and that the parent/guardian's signature is included. Additionally, the form should be completed by the person administering the medication or their designee. Other related forms that may be used for similar purposes include the Child Health Care Plan, which includes information about the child's medical history, and the Release of Information, which is used to provide access to the child's medical records.