2017 FORM MASH permission - Amazon Web Services Word - 2017_FORM_MASH_permission.docx Created Date...
Transcript of 2017 FORM MASH permission - Amazon Web Services Word - 2017_FORM_MASH_permission.docx Created Date...
Agoonoree 2017
MASH PERMISSION
2017_Agoonoree_FORM_MASH_permission
I give permission for my child _____________________________________________________________
[name of Scout / Guide / Venturer / Guest]
1. PARACETAMOL
to receive oral paracetamol at correct dosage for age and according to Agoonoree nurse initiated medication guidelines which meet national standards for care.
Parent/Guardian name: ____________________________ Signature: __________________________ Date: _______________
Note: paracetamol will be given if a valid signed form is held by Agoonoree organisers.
If a form is not on 2017 file we will contact by phone the parent/guardian or alternative contact person in order of priority as listed on the person’s application seeking to obtain verbal permission to give the medication.
2. HEAD LICE
if needed, to have hair treated according to Agoonoree nurse initiated management plan of shampoo and combing.
Parent/Guardian name: ____________________________ Signature: __________________________ Date: _______________
Note: If head lice or nits are confirmed for an individual, MASH will coordinate the required treatment of the whole Patrol. Treatment is a commercially made, natural shampoo of tea tree and lavender oils and combing out with a special comb.