| Participant |
Type |
| {{ $client_name ??'' }} |
{{ config('constant.prn_type_list')[$data['type']]??'' }} {{ !empty($data['type']) && $data['type'] == "other" ? ":- " . $data['type_other'] : '' }} |
| PRN Medication Authority Form |
| Medic Alert Number (if relevant): |
Review Date for this form: |
Concession Card No: |
| {{ $data['medic_alert_number'] ??'' }} |
{{ $data['review_date']??'' }} |
{{ $data['concession_card_no']??'' }} |
| Medicare NO: |
Allergies (If any): |
|
| {{ $data['medicare_no'] ??'' }} |
{{ $data['allergies']??'' }} |
|
@if (!empty($Medication))
| Medication required: |
| Name of Medication/s |
Dosage (amount) |
Administration Time |
Route of medication |
Start Date |
End Date |
@foreach ($Medication as $item)
| {{ $item['medication_name'] ?? '' }} |
{{ $item['dosage'] ?? '' }} |
{{ $item['administration_time'] ?? '' }} |
{{ $item['route_of_medication'] ?? '' }} |
{{ $item['start_date'] ?? '' }} |
{{ $item['end_date'] ?? '' }} |
@endforeach
|
@endif
Medication Storage:
Authorisation: |
| Name of Medical/health practitioner: |
Professional Role: |
Signature: |
| {{ $data['name_of_health_practitioner'] ??'' }} |
{{ $data['professional_role']??'' }} |
{{ $data['signature']??'' }} |
| Contact Detail: |
Date: |
|
| {{ $data['contact_details'] ??'' }} |
{{ $data['authorisation_date']??'' }} |
|
| Name of Parent/Carer: |
Signature: |
Date: |
| {{ $data['name_of_parent_carer'] ??'' }} |
{{ $data['parent_sign']??'' }} |
{{ $data['parent_sign_date']??'' }} |