TX HHS Form 7255. Medication Authorization

Form 7255 is a standardized document used in Texas child-care operations to record the administration of medication to children. Although it looks simple at first glance, this form carries important regulatory weight: it helps providers demonstrate compliance with Texas Administrative Code (TAC) §§744.2655, 746.3805, and 747.3605, all of which outline strict rules for medication handling, parental consent, and staff responsibilities. Understanding how to complete the form properly protects both the child-care facility and the families it serves.

Purpose and When the Form Is Required

This form is required any time child-care staff administer medication to a child during operating hours. It documents:

• The parent’s authorization for each medication
• The medication name and dosage
• The exact time the medication must be given
• The staff member who administered the medication
• Verification that the correct dosage was actually given

The form is not necessary when medication is administered exclusively by a parent on-site, nor when no medication is given at all during a specific month.

Who May Complete and Use This Form

The form is used by licensed child-care centers, before-school and after-school programs, and licensed or registered homes. Only authorized staff trained in medication administration may complete the “Dosage Given” and “Employee’s Full Name” fields. Parents or legal guardians must provide the initial written authorization.

Legal and Regulatory Background

Texas Administrative Code requires child-care providers to maintain written documentation every time a medication is administered. The rules exist to ensure that:

• Medication is not given without clear parental consent
• Staff follow the precise dosage instructions
• Facilities maintain accurate logs for state inspections
• Providers avoid liability by keeping verifiable records

Failure to maintain proper documentation can lead to regulatory citations during inspections and may affect the facility’s license status.

Explanation of Each Section of Form 7255

Facility Name & Month

This identifies the operation and the reporting period. Inspectors routinely check that each facility maintains separate medication logs for each month.

Date

The specific date medication is administered. Missing dates are one of the most common compliance errors.

Child

The full legal name of the child receiving the medication. Nicknames should be avoided to prevent confusion.

Name of Medication

The exact name as written on the medication label. Providers should verify that the medication matches the child’s prescription or parent instructions.

Dosage

Indicate the prescribed or parent-approved dosage. This must match the pharmacy label unless the parent provides separate written physician instructions.

Time to Be Given (AM/PM)

The exact time(s) medication must be administered. Staff should avoid vague entries like “morning” or “afternoon.”

Parent’s Signature

This certifies parental approval. A missing signature invalidates the authorization and medication cannot legally be given.

Dosage Given & Time Given

The staff member records the actual dosage and time it was administered. If the dosage differs—even slightly—from the authorization, staff must document the reason.

Employee’s Full Name

The name of the individual who administered the medication. Initials are not allowed under TAC requirements.

Typical Mistakes to Avoid

• Missing parent signatures
• Incomplete medication names
• Incorrect or approximate times (e.g., “around 1 PM”)
• Writing initials instead of full employee names
• Not logging missed doses or child refusal
• Mismatched dosage instructions vs. what is given

Practical Advice for Filling Out the Form

• Verify medication labels before accepting them from parents.
• Record information immediately—delayed entries lead to errors.
• Use one row for each medication event; don’t combine entries.
• If a child refuses medication, document it clearly.
• Store completed forms for inspection according to TAC retention rules.

Examples of Real-Life Situations Where Form 7255 Is Needed

• A child has a midday antibiotic dose for an ear infection during the school week.
• A parent drops off an inhaler for asthma and authorizes its use before outdoor play.
• A child needs a scheduled ADHD medication at exactly noon each day.
• A toddler requires allergy medication following exposure to seasonal pollen.

Documents Commonly Attached

• Prescription label with child’s name
• Physician dosage instructions (if different from label)
• Parent's written note describing symptoms and timing for over-the-counter medication
• Emergency action plan for chronic conditions like asthma or severe allergies

FAQ

Do parents need to sign the form every time medication is given?

Parents generally sign once per medication, but new authorization is required when dosage or timing changes.

Can staff administer over-the-counter medication?

Yes, but only with explicit written parental instructions that match the dosage appropriate for the child’s age and weight.

What if a child misses a dose?

Document the missed dose and notify the parent. Do not adjust the next dose unless a physician has provided instructions.

Can the facility accept medication without the original label?

No. Medication must be in its original container with clear labeling.

Who reviews this form during inspections?

Child Care Regulation (DFPS) inspectors review monthly logs to ensure the center complies with TAC documentation requirements.

Micro-FAQ (Short Answers)

• Purpose: Records medication administered to children in care.
• Who fills it: Authorized child-care staff.
• Parent signature: Required before any medication is given.
• Time requirements: Exact times must be documented.
• Attachments: Medication label, physician instructions.
• Submitted to: Maintained by the facility for inspection.
• When needed: Any time staff provide medication during care hours.
• Legal basis: Required under TAC §§744.2655, 746.3805, 747.3605.

Related Forms

• Texas Child Allergy Action Plan
• Daily Health Check Log
• Incident/Illness Report Form
• Emergency Medication Authorization

Form Details

• Form Name: Medication Authorization
• Form Number: 7255
• Jurisdiction: State of Texas
• Regulations: TAC §§744.2655, 746.3805, 747.3605
• Edition Date: April 2018-E