Yogies Playhouse Medication Record Child Name: DOB: Please be advised that we cannot administer any medication without a letter from the doctor, or a chemist sticker with the correct name and dosage clearly written on it. To be completed by Parent/Guardian Name of Medication Dosage Last Administered Time Date Method of administration Parent Name To be completed by Educators Name of Medication Medication Administered Time Date Administered by Name To be administered next Time Date Dosage Administered Witnessed by Name Signed Parent Signature Expiry Date Signed To be completed by Parent/Guardian Name of Medication Dosage Last Administered Time Date Method of administration To be administered next Time Date Parent Name Parent Signature To be completed by Educators Name of Medication Administered by Name Medication Administered Time Date Signed Dosage Administered Witnessed by Name Expiry Date Signed Page | 1 Yogies Playhouse Medication Record To be completed by Parent/Guardian Name of Medication Dosage Last Administered Time Date Method of administration To be administered next Time Date Parent Name Parent Signature To be completed by Educators Name of Medication Administered by Name Medication Administered Time Date Dosage Administered Witnessed by Name Signed Expiry Date Signed To be completed by Parent/Guardian Name of Medication Dosage Last Administered Time Date Method of administration To be administered next Time Date Parent Name Parent Signature To be completed by Educators Name of Medication Administered by Name Medication Administered Time Date Signed Dosage Administered Witnessed by Name Expiry Date Signed Page | 2