Printable Contracts

   Authorization To Administer Medication

Create your own printable contract — FREE!

Formatted and ready to use with Microsoft Word, Google Docs, or any other word processor that can open the .DOC file format.

Authorization to Administer Medication to Minor

Child Name: _________________________________

Birthdate: _________________________________

Guardian Name: _________________________________

Facility Name: _________________________________

Address: _________________________________

I, ___________________________, the legal guardian of the child named above, hereby authorize certified employees of _________________________________ to administer the following medication(s) to said child:

Medication: ___________________ Dose: ____________ Time(s): __________________

Medication: ___________________ Dose: ____________ Time(s): __________________

Medication: ___________________ Dose: ____________ Time(s): __________________

Medication: ___________________ Dose: ____________ Time(s): __________________

This authorization shall remain in effect from __________ to __________.


Guardian  _________________________ Date __________

Employee _________________________ Date __________

Create your own printable contract — FREE!

Formatted and ready to use with Microsoft Word, Google Docs, or any other word processor that can open the .DOC file format.


Index of Printable Contract Examples

DISCLAIMER: The contracts contained on PrintableContracts.com are not to be considered as legal advice. All content is for informational purposes, and Savetz Publishing makes no claim as to accuracy, legality or suitability. The site owner shall not be held liable for any errors, omissions or for damages of any kind.