Authorization To Dispense Authorization to Dispense External Preparations 590-1-1-20 (1) Parental Authorization. Except for first aid, personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child’s physician or parent. Such authorization will include, When applicable, date; full name of the child; name of the medication; prescription number; if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent. Child’s name: I give permission to apply one or more of the following topical ointments/preparations to my child in accordance with the directions on the label of the container. Baby Wipes Band- aids Neosporin or similar ointment Bactine or similar first aid spray Sunscreen Insect Repellent Non- Prescription ointment (such as A&D, Destin, Vaseline) Other (please specify) Parent/ Guardian Signature Date Send Now Admissions team looks forward to learning about you and your family.