Medication Administration Agreement

I, recognize that my duties as a service provider for the Lo-Se-Ca Foundation may require the administration of medications to Individuals receiving services. Medications will be administered ONLY as directed by the Individual’s physician or pharmacist. Any deviations in administration must be reported immediately to the pharmacist and my supervisor and instructions are to be followed. I will also complete a medication incident report form immediately and scan and email or fax it to the head office.



I understand that the use of home remedies including herbal remedies is prohibited without consent from the guardian and the physician and/or pharmacist.

I will share relevant medical information only as needed, in a manner that respect the individual’s dignity and respect and takes into account the Freedom of Information of Privacy Act (FOIP).


I understand that deliberate deviations from this policy may result in termination of my employment with Lo-Se-Ca Foundation.



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Signature Certificate
Document name: Medication Administration Agreement
lock iconUnique Document ID: ccefb7810629121ffab06bf47327155c540574df
Timestamp Audit
October 4, 2018 2:19 pm MDTMedication Administration Agreement Uploaded by Rebecca McLeod - IP