Get Asthma Action Plan.pdf - Swsd K12 Pa 2020-2025

Filling out the Asthma Action Plan is an essential step to ensure that students with asthma receive proper care and management during school hours. This guide will help you navigate the process of completing the form accurately and efficiently.

Follow the steps to complete the Asthma Action Plan form online.

1. Click ‘Get Form’ button to access the Asthma Action Plan.PDF - Swsd K12 Pa and open it in your preferred editor.
2. Begin by completing the student information section, including the student's name, birth date, and school details such as building, grade, and room.
3. Fill in the emergency contact information. This includes two parent/guardian names along with their home and work phone numbers.
4. List any asthma triggers that the student may have to help the school staff recognize potential emergencies.
5. Indicate whether you give permission for your child to carry their inhaler by selecting YES or NO. Include your signature and date at the bottom of this section.
6. Provide detailed information about all current medications prescribed, including the name, dose, time, and side effects.
7. In the section for the student's personal best peak flow and reportable peak flow, fill in the relevant measurements if available.
8. Outline the steps for an acute asthma episode clearly, detailing the actions to be taken.
9. Answer the questions regarding the student’s understanding of inhaler use and reporting to school staff by checking YES or NO.
10. Complete the physician's orders section by adding the physician's name, signature, telephone number, and date.
11. In the student agreement section, the student should read and sign the agreement, while a parent/guardian must also provide their signature and date.
12. Once you have filled out all sections, you can save your changes, download the completed form, or print it for submission.

Complete your Asthma Action Plan online today to ensure proper care for students with asthma.