Asthma Action Plan

If your child has asthma and requires mediction at the school, please have the doctor fill out this form. This will let the nursing staff know parameters for which to give your child the care he/she requires. 

The State of Illinois has passed new legislation to help provide consistent and complete asthma care for your child. It was effective January 1, 2017.

We are requesting a copy of your child’s Asthma Action Plan, to be kept on file in the Health Office at school.  It is preferred that the enclosed plan is signed by your physician, but the law does not require it.  Should your physician prefer a different form for asthma management, that is also acceptable.  This form does not take the place of the Physician’s Order for Medication Administration in School that are signed by both the physician and parent.

If you have any questions please feel free to email or call the Health Office at the school.

Thank you for your time and helping us comply with the new law.

Asthma Action Plan.pdf, 244.03 KB; (Last Modified on May 31, 2017)