Medication Administration Record

Add it, send the link, collect the answers

No setup and no credit card. The form below works exactly as it is.

  1. 1Add this form to your service — one sign-up, free.
  2. 2Send your educators the link. They open it on any device and enter your staff PIN — you won’t be asked while you’re signed in.
  3. 3Answers come back signed and land in your inbox as soon as they’re submitted.

What the medication administration record looks like

Every question, exactly as your educators will see it. Scroll inside the frame to read the whole form.

About the Medication Administration Record

A digital medication administration record built around Regulations 92 and 93 of the Education and Care Services National Regulations. This form captures medication details, expiry date, session type, dosage administered, method, time, and witness verification. The multi-step signing workflow ensures responsible person review and parent acknowledgement with previous administration details.

Also called

  • Medication record
  • Medication log
  • Medication administration record

What's on this form

Every question included in the medication administration record. Add, remove or reword any of them in the form builder.

Step 1 — Completed first

Filled in by the educator or responsible person

  • Child

    Child details

  • Medication Details

  • Child's Name Present On Medication?

    Yes / No

  • Name of Medication

    Short answer

  • Expiry Date of Medication

    Date

  • Who previously administered the medication?

    Short answer

  • Administration Details

  • Session Type

    • Before School Care
    • After School Care
    • Vacation Care

    Choose one

  • Date Of Administration

    Date

  • Time of Administration

    Time

  • Dosage Administered

    Short answer

  • Method of Administration

    Short answer

  • Person who witnessed administration and checked dosage was correct

    Educator signature

  • Person Completing Form

    Educator signature

Step 2 — Responsible Person

Completed by a staff member at the service

  • Responsible Person Details

    Educator signature

Step 3 — Parent / Guardian

Sent to the parent or guardian to sign

  • Previous Administration

  • Date of Previous Administration

    Date

  • Time Of Previous Administration

    Time

  • Parent/Guardian Signature

    Signature

How this form gets signed

This template runs as a multi-step signing workflow. Each person is notified in turn, and every signature is timestamped and stored against the record.

  1. 1

    Responsible Person

    Signs inside the service, using a staff PIN

  2. 2

    Parent/Guardian

    Signs externally — receives a secure link by email, no account needed

Australian regulations this form supports

The medication administration record is built around the Education and Care Services National Regulations. These are the regulations it helps you meet.

Reg 92

Medication record

A medication record must be kept for every child to whom medication is or is to be administered, including the child's name, the authorisation to administer it, and the details of each dose given.

Read the full text of Reg 92

(1) The approved provider of an education and care service must ensure that a medication record is kept that includes the details set out in subregulation (3) for each child to whom medication is or is to be administered by the service. (2) A family day care educator must keep a medication record that includes the details set out in subregulation (3) for each child being educated and cared for by the educator as part of a family day care service to whom medication is or is to be administered. (3) The details to be recorded are— (a) the name of the child; (b) the authorisation to administer medication (including, if applicable, self-administration), signed by a parent or a person named in the child's enrolment record as authorised to consent to administration of medication; (c) the name of the medication to be administered; (d) the time and date the medication was last administered; (e) the time and date, or the circumstances under which, the medication should be next administered; (f) the dosage of the medication to be administered; (g) the manner in which the medication is to be administered; (h) if the medication is administered to the child— (i) the dosage that was administered; and (ii) the manner in which the medication was administered; and (iii) the time and date the medication was administered; and (iv) the name and signature of the person who administered the medication; and (v) if another person is required under regulation 95 to check the dosage and administration, the name and signature of that person.

Reg 93

Administration of medication

Medication must not be administered to a child unless that administration is authorised and the medication is given in accordance with regulation 95 or 96.

Read the full text of Reg 93

(1) The approved provider of an education and care service must ensure that medication is not administered to a child being educated and cared for by the service unless— (a) that administration is authorised; and (b) the medication is administered in accordance with regulation 95 or 96. (2) The approved provider of an education and care service must ensure that written notice is given to a parent or other family member of a child as soon as practicable, if medication is administered to the child under an authorisation referred to in subregulation (5)(b). (3) A nominated supervisor of an education and care service must ensure that medication is not administered to a child being educated and cared for by the service unless— (a) that administration is authorised; and (b) the medication is administered in accordance with regulation 95 or 96. (4) A family day care educator must ensure that medication is not administered to a child being educated and cared for by the educator as part of a family day care service unless— (a) that administration is authorised; and (b) the medication is administered in accordance with regulation 95 or 96. (5) In this regulation the administration of medication to a child is authorised if an authorisation to administer the medication— (a) is recorded in the medication record for that child under regulation 92; or (b) in the case of an emergency, is given verbally by— (i) a parent or a person named in the child's enrolment record as authorised to consent to administration of medication; or (ii) if a parent or person named in the enrolment record cannot reasonably be contacted in the circumstances, a registered medical practitioner or an emergency service.

Reg 95

Procedure for administration of medication

How medication must actually be given: from its original container, bearing the original label and instructions — and, where prescribed, the child's name — before the expiry or use-by date, and in accordance with any instructions attached to it or given by a registered medical practitioner. Except in a family day care service or a service permitted to have only 1 educator, a second person must check the dosage and the child's identity. Subject to regulation 96.

Read the full text of Reg 95

Subject to regulation 96, if medication is administered to a child being educated and cared for by an education and care service— (a) the medication must be administered— (i) if the medication has been prescribed by a registered medical practitioner, from its original container, bearing the original label with the name of the child to whom the medication is to be administered, and before the expiry or use by date; or (ii) from its original container, bearing the original label and instructions and before the expiry or use by date; and (b) the medication must be administered in accordance with any instructions— (i) attached to the medication; or (ii) any written or verbal instructions provided by a registered medical practitioner; and (c) except in the case of a family day care service or an education and care service that is permitted to have only 1 educator to educate and care for children, the following must be checked by a person other than the person administering the medication— (i) the dosage of the medication to be administered; (ii) the identity of the child to whom the medication is to be administered.

Provided for information only and may not reflect the latest amendments. Refer to the Education and Care Services National Regulations (NSW) for the official legal text.

Where this form fits

The medication administration record is part of these jobs — each guide walks through the whole sequence and the other forms that go with it.

Questions about the medication administration record

What is the medication administration record used for?

A digital medication administration record built around Regulations 92 and 93 of the Education and Care Services National Regulations. This form captures medication details, expiry date, session type, dosage administered, method, time, and witness verification. The multi-step signing workflow ensures responsible person review and parent acknowledgement with previous administration details.

Who fills in the medication administration record?

The medication administration record is completed by educators or the responsible person at the service. Staff open it on any device and sign with a service PIN, so there's no separate login to manage. It then moves through 2 signing steps — Responsible Person and Parent/Guardian — with each signature timestamped against the record.

Which regulations is the medication administration record built around?

It is built around Reg 92, Reg 93 and Reg 95 of the Education and Care Services National Regulations. Reg 92 covers medication record. Reg 93 covers administration of medication. Reg 95 covers procedure for administration of medication. Check the form against the regulation text for your service before you use it.

Is the medication administration record the same as a medication record?

Yes. Different services use different names for this form — it is also called medication record, medication log and medication administration record. They all describe the same record, and this template covers it. You can rename it to whatever your service already calls it.

Can I change the questions on the medication administration record?

Yes. The template comes with 20 fields ready to go, but you can add, remove, reword or reorder anything in the drag-and-drop form builder, and add your own conditional logic and signing steps. Your changes only affect your service's copy.

Is the medication administration record free?

Yes — the medication administration record is free to use on the Childcare Forms free plan. No credit card is required to create an account and start sending it.

Ready to use it?

Create a free account, change anything you want, and send it to your first family. No credit card needed.