Form CCL027-SPA Authorization for Dispensing Medications to Children and Youth Long-Term Medications (Prescription and Non-prescription) - Kansas (English / Spanish)

Form CCL027-SPA Authorization for Dispensing Medications to Children and Youth Long-Term Medications (Prescription and Non-prescription) - Kansas (English / Spanish)

What Is Form CCL027-SPA?

This is a legal form that was released by the Kansas Department of Health & Environment - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form CCL027-SPA?A: Form CCL027-SPA is an authorization form for dispensing medications to children and youth in Kansas.

Q: What does the form authorize?A: The form authorizes the dispensing of long-term medications, both prescription and non-prescription, to children and youth.

Q: Who can fill out this form?A: This form can be filled out by the parent or legal guardian of the child or youth.

Q: Is this form available in both English and Spanish?A: Yes, this form is available in both English and Spanish.

Q: How long is this authorization valid for?A: This authorization is valid for one year from the date of signature.

Q: What information is required on the form?A: The form requires information such as the child's name, date of birth, medication details, dosage instructions, and emergency contact information.

Q: Are there any additional requirements for filling out this form?A: Yes, the form must be signed by a healthcare provider and include their contact information.

Q: Can this form be used for multiple children?A: No, this form is only valid for one child or youth.

Q: Can this form be used for short-term medications?A: No, this form is specifically for authorizing the dispensing of long-term medications for children and youth.

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Form Details:

  • Released on September 1, 2003;
  • The latest edition provided by the Kansas Department of Health & Environment;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form CCL027-SPA by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Kansas Department of Health & Environment.

Download Form CCL027-SPA Authorization for Dispensing Medications to Children and Youth Long-Term Medications (Prescription and Non-prescription) - Kansas (English / Spanish)

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