Get Ny Asthma Medication Administration Form 2023-2026

Filling out the NY Asthma Medication Administration Form online can streamline the process of ensuring your child receives the appropriate asthma care at school. This guide will walk you through each section of the form in a clear and supportive manner.

Follow the steps to effectively complete the form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the online editor.
2. Enter the student's last name, first name, middle initial, and date of birth in the designated fields. Then fill in the OSIS number, DOE district, and grade/class.
3. Mark the appropriate sex option for the student by selecting either 'Male' or 'Female'.
4. Provide the school's name, ATS DBN, address, and borough where the student is enrolled.
5. Have the health care practitioner complete the diagnosis section, including the control and severity based on NAEPP Guidelines.
6. Complete the student asthma risk assessment questionnaire by selecting 'Yes', 'No', or 'Unknown' for each question regarding asthma history and recent treatments.
7. List any home medications the student may be taking, including over-the-counter medications, and specify the dosages.
8. Indicate the student's skill level for medication administration, choosing from options such as nurse-dependent, supervised, or independent.
9. Fill out the sections for quick relief in-school medication, indicating the types of medications, dosages, and any special instructions.
10. Provide the health care practitioner's information, including their name, title, license number, and signature along with the date.
11. Ensure that the parent/guardian completes and signs the second page of the form, providing their contact information and emergency contact details.
12. Once all fields are completed, review the document for accuracy. Save changes, download, print, or share the form as needed.

Complete your documents online today to ensure timely processing for your child's asthma management.