MEDICAL FORM

Medcation Waiver

MEDICATION WAIVER

This waiver allows the following_________________________________________ to supply ____________________________________ with his/her prescribed/non-prescribed medication as per directions on bottle. All medication will be in its original container and as for prescribed medication the person’s name and medical professionals’ information must be on the container.

By signing this waiver you are releasing the above from any and all liability in relation to the handling of the medication.

Medication Directions