添付書類 3部
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登園許可届
※医師に「登園許可届」の記入を依頼して下さい。
※保護者の自己判断ではなく、医師の診断を受けた上で保護者の方がご記入下さい。
与薬依頼書
風邪や感染症で受診した場合、「幼児園に通っているので、園で薬を飲まなくてもいいようにしてください」と医師にご相談下さい。医師と相談の結果やむを得ず園での保育時間中に与薬が必要になった場合に限り「与薬依頼書」を記入の上、「与薬依頼書」と「薬」を持参して下さい。
Rating
50
Translation / English
- Posted at 07 Mar 2017 at 11:52
Attachment: 3 documents
* Please copy the documents on other pages
Permission of attendance
* Please ask the doctor for filling permission of attendance.
* Make sure parents don’t fill in with their will only but under the doctor’s diagnosis.
Request for medication
In case your child catches a cold or is infected, lease consult to your doctor so that there is no need for your child to take medicines in the kindargarden. A filled-in request for medication and medicines can be brought to the kindargarden only when the doctor concluded that medicines must be taken during nursery hours.
* Please copy the documents on other pages
Permission of attendance
* Please ask the doctor for filling permission of attendance.
* Make sure parents don’t fill in with their will only but under the doctor’s diagnosis.
Request for medication
In case your child catches a cold or is infected, lease consult to your doctor so that there is no need for your child to take medicines in the kindargarden. A filled-in request for medication and medicines can be brought to the kindargarden only when the doctor concluded that medicines must be taken during nursery hours.
Rating
44
Translation / English
- Posted at 07 Mar 2017 at 11:50
3 copies of attachment
Please make use of the following page document.
Attendance permission report
※Please ask attendance doctor for writing down the 'Attendance permission report'
※Please make sure that after asking the doctor's check not the guardian self check, and guardians
will write down the Attendance permission report.
※The additional medicine asking report
In the case of asked the doctor for catching cold and infection, please ask for the doctor,'please arrange not to take the medicine at the kindergarden by commuting'. Only the case that the additional medicine is needed during the child caring time even though after the result of asking the doctor,please write down the 'The additional medicine asking report' and bring both 'The additional medicine asking report' and 'Medicine'.
Please make use of the following page document.
Attendance permission report
※Please ask attendance doctor for writing down the 'Attendance permission report'
※Please make sure that after asking the doctor's check not the guardian self check, and guardians
will write down the Attendance permission report.
※The additional medicine asking report
In the case of asked the doctor for catching cold and infection, please ask for the doctor,'please arrange not to take the medicine at the kindergarden by commuting'. Only the case that the additional medicine is needed during the child caring time even though after the result of asking the doctor,please write down the 'The additional medicine asking report' and bring both 'The additional medicine asking report' and 'Medicine'.
Rating
50
Translation / English
- Posted at 07 Mar 2017 at 11:41
Attached sheet, three copies.
*Kindly copy a document of other page and use it.
A notice of permission for attendance.
*Please request a doctor to write down on this notice.
*Please write down on this notice by curator after getting advice from a doctor.
Medication request document
In case of seeing a doctor due to cold or infectious, kindly consult so that your child no need to take medicines during his attend in preschool.
In only case that your child has take medicines during day care time despite of consulting with a doctor, please write down in "medication request document", and take "that" and "medicines" with you.
*Kindly copy a document of other page and use it.
A notice of permission for attendance.
*Please request a doctor to write down on this notice.
*Please write down on this notice by curator after getting advice from a doctor.
Medication request document
In case of seeing a doctor due to cold or infectious, kindly consult so that your child no need to take medicines during his attend in preschool.
In only case that your child has take medicines during day care time despite of consulting with a doctor, please write down in "medication request document", and take "that" and "medicines" with you.
下記のことが守られない場合は与薬できないこともありますのでご了承下さい。
・薬の容器や袋には必ずクラス名と園児名を記載して下さい。
・飲み薬は一回分の量に分けてお持ち下さい。
・薬と与薬依頼書はクリアパックに入れスタッフに直接手渡しして下さい。
・与薬できるのは医師から処方された薬のみとなります。（市販薬は与薬できません。）
医師の指示により、やむを得ず保育時間中における与薬が必要となり、保護者の責任において、幼児園での園児に対する与薬を行って頂きたく依頼いたします。
園児名
保護者名
Rating
50
Translation / English
- Posted at 07 Mar 2017 at 12:02
Please note, if you cannot follow the following points, we may not be able to give you medicine.
・Please be sure to write the class and child's name on the container of medicine.
・Please bring oral medicine divided for each doze.
・Please directly hand your medicine and the application of giving medicine in a clear bag to our staff.
・We can only give your children the medicine prescribed by doctor. (We cannot give your children medicine on the market.)
I apply for the medicine to give my child in the kindergarden by his or her paprents' responsibility as it is necessary to give medicine to my child during nursing time at any means by doctor's order.
・Please be sure to write the class and child's name on the container of medicine.
・Please bring oral medicine divided for each doze.
・Please directly hand your medicine and the application of giving medicine in a clear bag to our staff.
・We can only give your children the medicine prescribed by doctor. (We cannot give your children medicine on the market.)
I apply for the medicine to give my child in the kindergarden by his or her paprents' responsibility as it is necessary to give medicine to my child during nursing time at any means by doctor's order.
Rating
50
Translation / English
- Posted at 07 Mar 2017 at 11:53
If you can't promise as below, there is a possibility that we can't give your child medicines. Kindly note.
・please mention the name of the class and your child on the container or pouch for medicines without fail.
・in case of medicines for internal use, please separate the quantity per one time.
・please put the medicines and medicine request document into some transparent package, and hand them to staff directly.
・we can give the medicine prescribed by a doctor only.(we can't give OTC..)
As per doctor's instruction, he/she need to take medicines during day care time necessarily. Therefore, I request you to give some medicines to my child under the responsibility of curator.
Child Name
Curator Name
・please mention the name of the class and your child on the container or pouch for medicines without fail.
・in case of medicines for internal use, please separate the quantity per one time.
・please put the medicines and medicine request document into some transparent package, and hand them to staff directly.
・we can give the medicine prescribed by a doctor only.(we can't give OTC..)
As per doctor's instruction, he/she need to take medicines during day care time necessarily. Therefore, I request you to give some medicines to my child under the responsibility of curator.
Child Name
Curator Name
Rating
44
Translation / English
- Posted at 07 Mar 2017 at 12:02
Please accept it when no additional medicine is allowed in the case of not making the promise written below.
・Please write the class ans name down the medicine container and package.
・Please bring the medicine separatelly for 1 time amount.
・The medicine and additional medicine asking report must be put into the clear pack and handle them to a staff.
・The additional medicine is only given by the doctor. (The medicine that is sold is not additionable.)
We ask for the the way for additional medicine at the kindergarden for the children, accoadind to the doctors indication, when the additional medicine id needed during the child care time Inevitably, and on the guardian resposibility.
・Please write the class ans name down the medicine container and package.
・Please bring the medicine separatelly for 1 time amount.
・The medicine and additional medicine asking report must be put into the clear pack and handle them to a staff.
・The additional medicine is only given by the doctor. (The medicine that is sold is not additionable.)
We ask for the the way for additional medicine at the kindergarden for the children, accoadind to the doctors indication, when the additional medicine id needed during the child care time Inevitably, and on the guardian resposibility.
Rating
50
Translation / English
- Posted at 07 Mar 2017 at 11:47
Please be aware that medication can only be given under the following conditions:
・Please write the child's name and class name on the medicine container or bag.
・For oral medicine, please bring the medication already separated into single dosages.
・Please put the medication and the doctor's written prescription in a clear packet, and hand it directly to a staff member.
・We can only give medication to children that has been prescribed by the doctor. (We cannot give over-the-counter medicines.)
Regrettably, we can only give medication dependent upon a doctor's written instructions. We trust that the children's guardians will assume responsibility for the giving of medication to pupils at this kindergarten.
Kindergarten Pupil's Name
Guardian's Name
・Please write the child's name and class name on the medicine container or bag.
・For oral medicine, please bring the medication already separated into single dosages.
・Please put the medication and the doctor's written prescription in a clear packet, and hand it directly to a staff member.
・We can only give medication to children that has been prescribed by the doctor. (We cannot give over-the-counter medicines.)
Regrettably, we can only give medication dependent upon a doctor's written instructions. We trust that the children's guardians will assume responsibility for the giving of medication to pupils at this kindergarten.
Kindergarten Pupil's Name
Guardian's Name
依頼日
医療機関名（担当医師名）
病名
薬の種別：与薬方法（用法・用量等）
内服薬：時間 食(前・間・後) 分
方法 そのまま・水で溶く・その他
塗り薬：回数 回（時間 ） 患部
点眼薬：患部（左目・右目）
注意事項
処理欄
・受付者
・与薬者
・与薬時間
給食費調整届
以下の期間欠席するため、給食費の調整を希望します。
欠席期間
対象保育日数
※「給食費調整届」の提出締め切りは、前月の3日までです。
Rating
52
Translation / English
- Posted at 07 Mar 2017 at 11:47
Request day
Medical institution name (medical attendant name)
Name of disease
Classification of the medicine: Administration method (use, dose, etc.)
Oral medicine: Time minutes (before, between, after) meal
Method As is, dissolve with water, other
Ointment: Number of times time (s) Time Affected part
Eye drops: Affected part (left eye, right eye)
Instructions
Process column
・Person of reception
・Administration person
・Administration time
Report of lunch costs adjustment
I hope for the adjustment of the lunch costs because I will be absent during the following periods.
Absence period
Target nursery days
※ The presentation deadline of "the report of lunch costs adjustment" til 3 months before.
Medical institution name (medical attendant name)
Name of disease
Classification of the medicine: Administration method (use, dose, etc.)
Oral medicine: Time minutes (before, between, after) meal
Method As is, dissolve with water, other
Ointment: Number of times time (s) Time Affected part
Eye drops: Affected part (left eye, right eye)
Instructions
Process column
・Person of reception
・Administration person
・Administration time
Report of lunch costs adjustment
I hope for the adjustment of the lunch costs because I will be absent during the following periods.
Absence period
Target nursery days
※ The presentation deadline of "the report of lunch costs adjustment" til 3 months before.
Rating
50
Translation / English
- Posted at 07 Mar 2017 at 11:50
Apply date
Name of medical institution (doctor in charge)
Disease name
Classification of drug: Medication method (usage and amount)
Oral medicine: Time meals (before, during, after) times
Method as it is/mix with water/others
Ointment: times times (time ) affected part
Eye drops: affected part (left eye/right eye)
Note
Processing space
・Recipient
・Prescriber
・Prescribed time
Application for adjusting meal provided
I would like to be adjusted the meal provided charges, as I will be absent for the following period.
Absent period
Subjected nurturing period
※"Application for meal charge adjustment"s closing date is to be don until 3 days before.
Name of medical institution (doctor in charge)
Disease name
Classification of drug: Medication method (usage and amount)
Oral medicine: Time meals (before, during, after) times
Method as it is/mix with water/others
Ointment: times times (time ) affected part
Eye drops: affected part (left eye/right eye)
Note
Processing space
・Recipient
・Prescriber
・Prescribed time
Application for adjusting meal provided
I would like to be adjusted the meal provided charges, as I will be absent for the following period.
Absent period
Subjected nurturing period
※"Application for meal charge adjustment"s closing date is to be don until 3 days before.
Rating
50
Translation / English
- Posted at 07 Mar 2017 at 12:06
Requested Days
Name of Medical Institution (Attending Doctor's Name)
Name of Illness:
Medicine Classification: Method of administering medication (directions, dosage, etc.)
Oral Medicine: Time - _____ minutes before/during/after eating
Directions: take as it is/dissolve in water/other
Ointments/Medical Creams: Apply _____number of times (____am/pm). Affected parts - ______
Eye Drops: Affected Part - (left eye/right eye)
Important Points to Note
Processing Field
・Receptionist
・Person administering medicine
・Time medication is to be administered
School Lunch Fee Adjustment Request
My child will be absent for the following period, so I'd like to request an adjustment of the school lunch fee.
Period of Absence
Number of Days at Childcare
※The deadline for the "School Lunch Fee Adjustment Request" is the 3rd day of the month preceding the child's absence.
Name of Medical Institution (Attending Doctor's Name)
Name of Illness:
Medicine Classification: Method of administering medication (directions, dosage, etc.)
Oral Medicine: Time - _____ minutes before/during/after eating
Directions: take as it is/dissolve in water/other
Ointments/Medical Creams: Apply _____number of times (____am/pm). Affected parts - ______
Eye Drops: Affected Part - (left eye/right eye)
Important Points to Note
Processing Field
・Receptionist
・Person administering medicine
・Time medication is to be administered
School Lunch Fee Adjustment Request
My child will be absent for the following period, so I'd like to request an adjustment of the school lunch fee.
Period of Absence
Number of Days at Childcare
※The deadline for the "School Lunch Fee Adjustment Request" is the 3rd day of the month preceding the child's absence.
Rating
50
Translation / English
- Posted at 07 Mar 2017 at 11:32
Requested date
Name of medical institution (name of doctor in charge)
The name of a disease
Drug classification: Drug administration method (usage, dosage, etc.)
Internal medicine: time (before, after, after) meal minutes
Method: as it is - Melt with water - Other
Ointment: number of times (hours) affected area
Eye drops: affected area (left eye / right eye)
Notes
Treatment field
· Receiver
· Medicinal agent
· Medicine duration
Feeding Fee Adjustment Notification
We would like to adjust lunch fee as we will be absent for the following times.
Absence period
Target childcare days
※ The deadline for submitting "Feeding Fee Adjustment Notification" is up to the 3rd of the previous month.
Name of medical institution (name of doctor in charge)
The name of a disease
Drug classification: Drug administration method (usage, dosage, etc.)
Internal medicine: time (before, after, after) meal minutes
Method: as it is - Melt with water - Other
Ointment: number of times (hours) affected area
Eye drops: affected area (left eye / right eye)
Notes
Treatment field
· Receiver
· Medicinal agent
· Medicine duration
Feeding Fee Adjustment Notification
We would like to adjust lunch fee as we will be absent for the following times.
Absence period
Target childcare days
※ The deadline for submitting "Feeding Fee Adjustment Notification" is up to the 3rd of the previous month.
「til 3 months before.」は、「is til 3 months before.」と訂正いたします。