Maryland youth camps may only give a camper medication, or let the camper self-administer it, when this form is completed in full. Clinicians see it before camp season: the prescriber writes the order for each medication, the parent consents, and the camp keeps the form so staff know the dose, timing, side effects and whether the child may carry emergency medicine.
The authorized prescriber completes Section I, the prescriber's authorization, and signs Section III if self-administration is approved. The parent or guardian completes Section II and co-signs any self-carry approval.
Download the current version from the source each time; forms change without notice.
Medication Administration Authorization Form (Youth Camps)
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Yes. The form says a new medication administration form must be completed at the beginning of each camp season, for each medication, and each time there is a change in dosage or time of administration. The authorization may not exceed one year.
Yes. Nonprescription medication, which the form says includes vitamins, homeopathic and herbal medicines, must be in the original container with instructions for use. Prescription medication must be in a container labeled by the pharmacist or prescriber.
Only if Section III is completed. Both the prescriber and the parent sign to approve self-administration and check whether the child may self-carry emergency medication. Self-carry is limited to emergency medicines, and the camp operator may still decline to permit it.