{"id":546,"date":"2022-12-06T11:59:48","date_gmt":"2022-12-06T16:59:48","guid":{"rendered":"https:\/\/andrewsmemorial.org\/childcare\/?page_id=546"},"modified":"2022-12-07T09:24:07","modified_gmt":"2022-12-07T14:24:07","slug":"permission-for-over-the-counter-topical-medications-and-fluoridated-toothpaste","status":"publish","type":"page","link":"https:\/\/andrewsmemorial.org\/childcare\/permission-for-over-the-counter-topical-medications-and-fluoridated-toothpaste\/","title":{"rendered":"Permission for Over-the-Counter Topical Medications and Fluoridated Toothpaste"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full wpforms-block\" id=\"wpforms-541\"><form id=\"wpforms-form-541\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"541\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/childcare\/wp-json\/wp\/v2\/pages\/546\" data-token=\"a6a453364c1a8db8b303e538737a85d2\" data-token-time=\"1775819992\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-541-field_2-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"2\"><label class=\"wpforms-field-label\">Child&#039;s Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-541-field_2\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][2][first]\" required><label for=\"wpforms-541-field_2\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-541-field_2-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][2][last]\" required><label for=\"wpforms-541-field_2-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-541-field_4-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-541-field_4\">Permission is given to apply the following (name\/type)<\/label><textarea id=\"wpforms-541-field_4\" class=\"wpforms-field-medium\" name=\"wpforms[fields][4]\" ><\/textarea><\/div><div id=\"wpforms-541-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-541-field_5\">Amount\/Dosage <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-541-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" required><div class=\"wpforms-field-description\">Fluoridated toothpaste should be a rice sized smear for children under 3 and pea sized for children 3 and over.<\/div><\/div><div id=\"wpforms-541-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-541-field_6\">Expiration date, if applicable<\/label><input type=\"text\" id=\"wpforms-541-field_6\" class=\"wpforms-field-medium wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\" dd\/mm\/yyyy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][6]\" placeholder=\"dd\/mm\/yyyy\" ><\/div><div id=\"wpforms-541-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-541-field_8\">Permission Start Date<\/label><input type=\"text\" id=\"wpforms-541-field_8\" class=\"wpforms-field-medium wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\" dd\/mm\/yyyy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][8]\" placeholder=\"dd\/mm\/yyyy\" ><div class=\"wpforms-field-description\">Permission may be given for up to 12 months. <\/div><\/div><div id=\"wpforms-541-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-541-field_9\">Permission End Date<\/label><input type=\"text\" id=\"wpforms-541-field_9\" class=\"wpforms-field-medium wpforms-masked-input\" data-rule-inputmask-incomplete=\"1\" data-inputmask-alias=\"datetime\" data-inputmask-inputformat=\" dd\/mm\/yyyy\" data-inputmask-inputmode=\"numeric\" name=\"wpforms[fields][9]\" placeholder=\"dd\/mm\/yyyy\" ><\/div><div id=\"wpforms-541-field_12-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"12\"><label class=\"wpforms-field-label\">Application area <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-541-field_12\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_12_1\" name=\"wpforms[fields][12]\" value=\"Diaper area only\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_12_1\">Diaper area only<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_12_2\" name=\"wpforms[fields][12]\" value=\"Face only\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_12_2\">Face only<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_12_3\" name=\"wpforms[fields][12]\" value=\"All exposed skin\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_12_3\">All exposed skin<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_12_4\" name=\"wpforms[fields][12]\" value=\"Toothbrush\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_12_4\">Toothbrush<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_12_5\" name=\"wpforms[fields][12]\" value=\"Other area\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_12_5\">Other area<\/label><\/li><\/ul><\/div><div id=\"wpforms-541-field_14-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-541-field_14\">If OTHER AREA, please specify<\/label><textarea id=\"wpforms-541-field_14\" class=\"wpforms-field-medium\" name=\"wpforms[fields][14]\" placeholder=\"Describe WHERE to apply the ointment, repellent, lotion, cream, powder or fluoridated toothpaste\" ><\/textarea><\/div><div id=\"wpforms-541-field_13-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"13\"><label class=\"wpforms-field-label\">Application needed <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-541-field_13\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_13_1\" name=\"wpforms[fields][13]\" value=\"Before going outside\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_13_1\">Before going outside<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_13_2\" name=\"wpforms[fields][13]\" value=\"After each diaper change\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_13_2\">After each diaper change<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_13_3\" name=\"wpforms[fields][13]\" value=\"After each bowel movement\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_13_3\">After each bowel movement<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_13_4\" name=\"wpforms[fields][13]\" value=\"Before tooth brushing\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_13_4\">Before tooth brushing<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-541-field_13_5\" name=\"wpforms[fields][13]\" value=\"Other need\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-541-field_13_5\">Other need<\/label><\/li><\/ul><\/div><div id=\"wpforms-541-field_15-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-541-field_15\">If OTHER NEED, please specify<\/label><textarea id=\"wpforms-541-field_15\" class=\"wpforms-field-medium\" name=\"wpforms[fields][15]\" placeholder=\"Describe WHEN to apply the ointment, repellent, lotion, cream, or powder\" ><\/textarea><\/div><div id=\"wpforms-541-field_16-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-541-field_16\">Application Instructions<\/label><textarea id=\"wpforms-541-field_16\" class=\"wpforms-field-medium\" name=\"wpforms[fields][16]\" placeholder=\"Describe HOW to apply the ointment, repellent, lotion, cream, or powder\" ><\/textarea><\/div><div id=\"wpforms-541-field_17-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"17\"><label class=\"wpforms-field-label\">Parent\/Guardian Approval <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-541-field_17\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][17][first]\" required><label for=\"wpforms-541-field_17\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-541-field_17-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][17][last]\" required><label for=\"wpforms-541-field_17-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><div class=\"wpforms-field-description\">I give permission to my child care provider to apply the medication listed above as instructed.<\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-invisible\" ><div class=\"g-recaptcha\" data-sitekey=\"6Lf3xZ8UAAAAALiIvE60AX9GlbM-3PmeLcdlAA8g\" data-size=\"invisible\"><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"541\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages\/546\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-541\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/andrewsmemorial.org\/childcare\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"class_list":["post-546","page","type-page","status-publish","hentry"],"jetpack_shortlink":"https:\/\/wp.me\/PbwKKy-8O","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages\/546","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/comments?post=546"}],"version-history":[{"count":2,"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages\/546\/revisions"}],"predecessor-version":[{"id":559,"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/pages\/546\/revisions\/559"}],"wp:attachment":[{"href":"https:\/\/andrewsmemorial.org\/childcare\/wp-json\/wp\/v2\/media?parent=546"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}