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Get and Sign Massachusetts Antipsychotic Medication Consent Form 2010-2022
Given Times medication to be given Reasons for medication Possible side effects Directions for storage Name and phone number of the prescribing health care practitioner Child s Health Care Practitioner Signature Date print name to authorize educator s to administer medication to my child as indicated above. Parent/Guardian Signature For topical non-prescription NOT applied to open wound / broken skin parent signature only -. Commonwealth of Massachusetts Department of Early...
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