Transcription of Autorization for Medication Administration - Florida
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Autorization for Medication Administration - Florida
Authorization for Medication Administration APD Client's Name_____ Date of Birth _____. Health Care Provider _____. I am a physician, physician's assistant, or Advanced Registered Nurse Practitioner licensed to practice in the State of Florida , and a provider of health care services for the above-named client receiving developmental disabilities from the Agency for Persons with Disabilities. It is my professional opinion, based on my knowledge of his/her health status and physical condition, that he/she is: _____ Fully capable of self-administering his/her medications; or _____ Requires supervision while self-administering his/her medications by a validated Medication Administration assistant; or _____ Requires Medication Administration by a validated Medication Administration assistant; or _____ _____.
Title: Autorization for Medication Administration Author: APD - Agency for Persons With Disabilities - State of Florida Created Date: 10/11/2010 11:55:33 AM
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