Please have your child’s physician complete/sign an Asthma Medicine Plan. This form must be completed in order to have an inhaler kept/administered at school. You will also need to sign/date the bottom portion of the form and leave emergency contact phone information. This form must be returned to the nurse.
*If you would like your child to carry and self administer their inhaler, please have the physician check the appropriate box on the Asthma
Medicine Plan form. If your physician allows your child to carry/self administer, then the Self Administration Medication Form is required.
The Self Administration Medication Form provided by SCUC-ISD needs to be signed by the parent and student and also returned to the nurse. If your physician does not allow your child to self carry, then you do not need to complete/return this form.
*If your student will be allowed to carry/self-administer their inhaler, I strongly encourage you to provide an additional inhaler to be kept in the clinic in case of emergencies.