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Asthma Action Plan and medication form

Asthma medication administration requires an Asthma Action Plan and a medication order form. Links for these forms are included below.

Please note: if your child had exercised or activity induced asthma, please make sure that your doctor fills out that section of the asthma action plan in order for he/she to receive medication before gym and/or recess. (this is located at the bottom of the green section (healthy zone) of the asthma action plan

If exercise triggers your asthma, take__________________ puff(s) ________minutes before exercise

Asthma Action Plan

Medication Administration form