Asthma Inhaler Policy

The PACNJ Asthma Treatment Plan is designed to help everyone understand the steps necessary for the individual student to achieve the goal of controlling asthma.

Parents/Guardians & Health Care Providers will discuss and then complete the following areas:

• Child’s peak flow range in the Healthy, Caution and Emergency sections on the left side of the form
• Child’s asthma triggers on the right side of the form
• Permission to Self-administer Medication section at the bottom of the form:

Discuss your child’s ability to self-administer the inhaled medications, check the appropriate box, and then both you and your Health Care Provider must sign and date the form