Get Asthma School Medication Form.doc. Aap Richmond Center-- Protecting Our Children Against Secondhand

Filling out the Asthma School Medication Form is essential for ensuring that students with asthma receive proper care while at school. This guide provides clear, step-by-step instructions on how to complete the form effectively to meet the needs of the students and comply with school policies.

Follow the steps to accurately complete the Asthma School Medication Form.

1. Click the ‘Get Form’ button to access the Asthma School Medication Form and open it for editing.
2. In the 'Student Information' section, provide the student's full name, date of birth, school, grade, teacher, and school year. Ensure that all information is accurate and up-to-date.
3. List any known drug allergies or reactions in the designated field. Also, fill in the student's height and weight to assist healthcare providers in medication administration.
4. Locate the 'Prescriber Authorization' section. Here, specify the medication prescribed, including options for HFA MDI and other alternatives. Circle the applicable medication as guided.
5. Indicate the dosage and whether the dose should be taken prior to activities. Include any additional notes necessary for medication administration.
6. In the 'Self-Medication' and 'Keep Medication on Person' sections, indicate whether the student is permitted to self-administer their medication and if they should keep the medication with them. Select 'Yes' or 'No' according to the child's needs.
7. Fill out the section regarding potential side effects and adverse reactions. Familiarize yourself with the common side effects listed to ensure informed responses to any reactions.
8. The prescriber must sign and date the form. They should also provide their stamp with their name, phone, and fax details.
9. The parent or guardian must read and sign the 'Parent Authorization' section. This includes authorizing the School Nurse to delegate medication administration to unlicensed personnel.
10. If the student is permitted to self-administer their medication, fill out the 'Self-Administration Authorization' section with the parent's signature and date.
11. Complete any additional sections as required, including the 'Asthma Symptom Assessment Score Sheet' and the 'Asthma Provider Feedback Form,' ensuring all scores and comments are appropriately filled in.
12. Finally, review the form for accuracy and completeness. Once all fields are filled, save the changes and choose to download, print, or share the form as necessary.

Begin filling out the Asthma School Medication Form online today to ensure your child receives the necessary support at school.