Page 50 - Handbook for House Staff
P. 50
Pupils taking long term prescribed medication
Name of Pupil:.................................................................................................................................................... Name of medication and dose:................................................................................................................................. Times to be taken:................................................................................................................................................................. Start Date:............/............../............
Quantity Supplied:....................................................................................... Date .............../.................../..............
DAY
Time Due
Taken
Time Due
Taken
Time Due
Taken
Weekly Balance
Does the pupil know when and how to take their medicine.? Yes/No (Delete as appropriate)
Signed: ................................................................................................. (Pupil)
Signed: ................................................................................................. (HouseM/Assistant)
Date: .............../.................../..............
Date: .............../.................../..............
Mel Tillman Nurse Manager
Weekly Balance
50
