Authorisation – Nappy Cream

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Authorisation – Nappy Cream

 

Child’s name                      ______________________________________________________________

Insert names of product supplied by service or supplied by parents if they don’t wish to use product supplied by service

Name of product              ____________________________________________________________

I authorise application of the product listed above to my child in accordance with the instructions contained on the product, service policies and recognised best practice guidelines.

I understand that:

  • if a medical practitioner prescribes an alternative nappy cream this authorisation will cease to apply
  • in all other cases this authorisation will remain current for 12 months unless I advise the Nominated Supervisor in writing that I’m withdrawing it
  • I will need to supply the product listed if I do not wish to use the product supplied by the service. The product must comply with service policies eg Nut Awareness Policy, and my child’s name must be clearly written on the product.

 

Parent’s Signature           _____________________________                   Date      ______________

Parent’s Name                  _____________________________

 

Parent’s Signature           _____________________________                   Date      ______________

Parent’s Name                  _____________________________

                               

 

 

 

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