Children’s Ministry at FBG – Medication Consent

Medication Consent Form & Medication Record

Please fill out this form if your child requires medication of any kind. It is First Baptist Greenville's policy to keep ALL prescription (Rx) and over-the-counter (OTC) medications in a secure place with the designated chaperone. At check-in, parents and participants MUST give all medications to staff and medications MUST be sent in the original bottle/container.

In case of emergency, please contact:
Name
Phone Number
 
Please list all information for each medication to be administered by a chaperone during the trip.
Name of medicine
Dose (amount)
Dose (instructions)
Last dose administered
 
The following OTC medications (or generic equivalent) are available from a chaperone. Please indicate if you give permission for your student to take these medicines "as needed" by checking the box. Only medicines that are checked and determined to be necessary will be administered at the discretion of the chaperone/staff. Administration of these medicines will be per label instructions unless otherwise indicated by your physician.
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