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Notify doctor if needed on day 4PseudophedrineAs directed on label for sinus congestionAllergy Capsules Diphenhydramine HCLAs directed on label for runny, itchy, nose, sneezing, scratchy throat, itchy/watery eyesAntacid/AntiflatulentAs directed on label for indigestion, stomach upset, excess gasCalcium CarbonateAs directed on label for heartburnDo not use antacid within 1 hour of administering psychotropic medicationAnti-diarrheaAs directed on label after loose bowel movementCough syrupAS directed on label for cough/congestionCough dropsAs directed on label for coughIpecac syrupAs directed on labelCalamine lotionAs directed on label for poison ivy, poison oak, poison sumac Anti-Itch cream/sprayApply to affected area as directed on label, do not use on broken skinDesenex powderAs directed on label fro Athletes footSunscreen lotionAs directed on label before exposure to sunlightSunburn lotion/creamAs directed on label for sunburnHydrogen PeroxideAs directed on label for cuts, scrapesFirst Aid sprayAs directed on label for cuts, scrapesTriple Antibiotic ointmentAs directed on label for cuts or scrapes and cover with dry sterile dressing if needed. Notify Dr of redness or swelling Warm/Cold PacksApply to affected/painful areas as neededFluoride RinseAs directed on label Stool SoftenerAs directed on label if no bowel movement in ___daysLaxativeAs directed on label, if no bowel movement in ___daysMilk of MagnesiaAs directed on label, if no bowel movement in ___ daysDandruff shampooAs directed on label    Physicians Signature Date %& ( 4 8 < P Q   + 4 j k ( )   E F ~  # $ i ;<wx'HJK0389zڻϳϳh8oCJaJh8o5CJaJh&&h8oCJaJh<h8oCJaJh<h8o5CJaJh8oh8o5CJ aJ hHXh8o5CJaJF%&l ( 0 < P $$Ifa$gd8odhgd8ogd8o$a$gd8oP Q _ ` a [RRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o [RRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o  [RRRR $Ifgd8okd"$$Ifl\ u$ G t0$644 layt8o  j [R $Ifgd8okd$$Ifl\ u$ G t0$644 layt8oj k z { | $Ifgd8ojkdD$$Ifl$$ t0$644 layt8o ( [RRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o( ) ? @ A [RRRR $Ifgd8okd@$$Ifl\ u$ G t0$644 layt8o [RRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o  [R $Ifgd8okdb$$Ifl\ u$ @ t0$644 layt8o     E $Ifgd8ojkd$$Ifl$$ t0$644 layt8oE F R S T ~ [RRRR $Ifgd8okdB$$Ifl\ u$ G t0$644 layt8o~  [RRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o [RRRR $Ifgd8okdd$$Ifl\ u$ G t0$644 layt8o # [RRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o# $ : ; < [RRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o [RRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o [RRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o;[RRRR $Ifgd8okd9 $$Ifl\ u$ G t0$644 layt8o;<NOPw[RRRR $Ifgd8okd $$Ifl\ u$ G t0$644 layt8owx[RRRR $Ifgd8okd[ $$Ifl\ u$ G t0$644 layt8oJ[RRRR $Ifgd8okd $$Ifl\ u$ G t0$644 layt8oJK[\][RRRR $Ifgd8okd} $$Ifl\ u$ G t0$644 layt8o[RRRR $Ifgd8okd $$Ifl\ u$ G t0$644 layt8o[RRRR $Ifgd8okd $$Ifl\ u$ G t0$644 layt8o8[RRRR $Ifgd8okd0 $$Ifl\ u$ G t0$644 layt8o89JKL[RRRR $Ifgd8okd $$Ifl\ u$ G t0$644 layt8oz}þh1h&&h8o>* h8o>*&&8Ǧ>*䴳8Ǧ䴳8Ǧ䴳&&8Ǧ䴳<h8oCJaJh8oCJaJ[RRRR $Ifgd8okdR$$Ifl\ u$ G t0$644 layt8o[RRRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o[RRRRR $Ifgd8okdt$$Ifl\ u$ G t0$644 layt8o[RRRRR $Ifgd8okd$$Ifl\ u$ G t0$644 layt8o[VVTgd8okd$$Ifl\ u$ G t0$644 layt8o,1h/ =!"#$% $$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8oM$$If!vh5$#v$:Vl t$65$yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55/ / yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5@55#v #v@#v#v:Vl t$65 5@55yt8oM$$If!vh5$#v$:Vl t$65$yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o$$If!vh5 5G55#v #vG#v#v:Vl t$65 5G55yt8o@@@ NormalCJ_HaJmH sH tH DAD Default Paragraph FontRi@R  Table Normal4 l4a (k(No Listj@j 8o Table Grid7:V0X%&l(0<PQ_`ajkz{|()?@AEFRST~#$:;<;<NOPwxJK[\]89JKL00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 00 0 0 0 0 00 0 0 0 0 000PQ_`ajk(;<wx89000000000000000000@p@D 00M @0%0$00K @0%0$0001M @0%0$01K @0%0$0001M @0%0$01K @0%0$00 @0%0$ 00 z &P  j (  E ~ # ;wJ8  !"#$%'()*+ ky1>  R25/6I9OWBTo8o61Sz(0<PQ_`ajkz{|()?@AEFRST~#$:;<;<NOPwxJK[\]89JKL@Xx_@UnknownGz Times New Roman5Symbol3& z Arial"qhنن0[0[Yr42qHX)?8o$Over The Counter Medication ApprovalOIT Leah.SmithOh+'0  , L X dpx(Over The Counter Medication ApprovalOIT Normal.dot Leah.Smith2Microsoft Office Word@F#@L>=@L>=0՜.+,0 hp  State of fb88[' %Over The Counter Medication Approval Title  !"#$%&'()*+,./012345789:;<=>?@ABCDEFGHIKLMNOPQSTUVWXY\Root Entry F@=^Data -'1Table6&WordDocument.XSummaryInformation(JDocumentSummaryInformation8RCompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q