Lowndes County, GA · Lowndes County
Medication Approval Form
Lowndes County DUI Court participants use this form to request approval for medications and provide prescription details to the treatment provider.
At a glance
- Issued by
- City of Lowndes County · Lowndes County, Lowndes County, Georgia
- Notarization
- Not required: file this form without a notary.
- Official source
- lowndescounty.com
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form lets a Lowndes County DUI Court participant request permission to take medication and records the medication name, dosage, approval, and expiration date. The participant is instructed to attach prescription copies and sign and date the request; a treatment provider also signs and dates it. The form explains that prescription changes require treatment provider approval and that positive screens after approval expires may result in sanctions.
Who needs it
A Lowndes County DUI Court participant requesting permission to take medication should complete this form and attach copies of the prescriptions.
How to submit it
Submit it to the county department named on the form; check the county website for current contact details.
About notarization
This form is signed and dated by the participant and treatment provider without a notary; attach copies of prescriptions, which the form does not say must be notarized.
How to submit this form
- 1
Download the Form
Download the Medication Approval Form.
- 2
Complete the Request
Enter your participant name and the requested medication name and dosage.
- 3
Gather Prescription Copies
Attach copies of any prescriptions.
- 4
Sign and Submit
Sign and date the form, obtain the treatment provider's signature and date, and submit it to the county department named on the form.
Frequently asked questions
- What is the Medication Approval Form for?
- It lets a Lowndes County DUI Court participant request permission to take medication and provide its name and dosage for approval.
- What should I attach to the form?
- Attach copies of any prescriptions. The form also asks the participant and treatment provider to sign and date it.
- Do I need a notary for the Medication Approval Form?
- No. The participant and treatment provider sign and date the form without a notary. Attach prescription copies; the form does not say they must be notarized.
- How do I submit the Medication Approval Form?
- Submit it to the county department named on the form; check the county website for current contact details.