Try for free

Virginia Child Day Center Medication Authorization

Virginia licensed child day centers use this VDOE model form under 8VAC20-781-510 before giving a child prescription or over-the-counter medication. The parent completes Section A for every medication. When a medication will be given for longer than 10 work days, the child's physician also completes Section B, certifying that it is medically necessary.

Who completes it

The parent or guardian completes and signs Section A for all medication authorizations. The child's physician completes and signs Section B for long-term prescription or over-the-counter medication.

Submitting and payment

How to submit it
The completed form is returned to the child day center that will give the medication.
Who pays
The form sets no fee and does not address payment for completing the physician's section.

Good to know

  • A parent-only authorization in Section A expires or must be renewed after 10 work days.
  • In Section B the physician lists the medications, dosage and times, special instructions and the effective start and end dates, then signs with a phone number.
  • The form is for licensed child day centers; it is a VDOE model form revised 11/2025, after child care licensing moved from VDSS to VDOE.
  • Virginia public schools use their own division-level medication forms, so this model form is not the school version.

Get the official form

Download the current version from the source each time; forms change without notice.

Medication Authorization Form For Prescription and Non-Prescription Medications

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

See how Vero Documents works

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

When does a Virginia child day center need a physician to sign?

Section B, the physician's certification, is required for long-term prescription and over-the-counter medication, meaning medication given for a duration that exceeds 10 work days. Shorter courses need only the parent's Section A.

What does the physician certify on the Virginia medication form?

The physician certifies that it is medically necessary for the listed medications to be given to the named child for longer than 10 work days, and lists the dosage and times, special instructions and effective dates.

Is the Virginia VDOE model form used in public schools?

No. It cites the licensing rule for child day centers, 8VAC20-781-510, and is a VDOE model form for those programs. Virginia public schools use medication authorization forms set by each school division, so the school supplies its own version.