A NOTE FROM THE REAGAN CLINIC REGARDING STUDENTS WITH ASTHMA:

The following is information regarding paperwork needed for your student to have an inhaler at Reagan during the next school next year.

• To have an inhaler in the clinic the “Asthma Action Plan”  (ASTHMA Form 2) should be signed by the physician as well as by the parent. If your student would like to carry an inhaler, this must be indicated on this form.

• For all students that will be carrying an inhaler, the “Authorization for Student to Carry and Self-Administer” (ASTHMA Form 3) form needs to be reviewed and signed by both parent and student.

• Also, please fill out the top portion of the “Criteria for Students with Authorization to Carry and Self-Administer a Prescribed Asthma Inhaler” (ASTHMA Form 4) and the “Questionnaire: Assessing Student Readiness to Self-Carry” (ASTHMA Form 5). These forms will be reviewed when the student checks into the clinic and receives a label stating that he or she has been cleared to carry an inhaler.

• We encourage students to have permission to carry their inhaler in the event of a field trip or before or after school hour activities. If your student is not carrying their inhaler and you have left an inhaler in the clinic please notify the clinic at least 3 days in advance if you would like for us to provide their medication for a field trip.

• If your student is to carry their inhaler, we do encourage you to leave an extra inhaler in the clinic in case of an emergency.

• We have also included an “ASTHMA DIARY” (ASTHMA Form 6) for your student’s personal use.

If you have any questions, please do not hesitate to contact us at (210) 356-1857 or email us at gheyla@neisd.net or pgonza24@neisd.net  -  FAX (210) 482-2222

Thank you!

Gigi Heyland Franklin, RN      Pam Gonzalez, LVN      Rose Mata, CA

  ALL INHALERS MUST HAVE NEW PAPERWORK & BE RELABELED EACH YEAR IN ORDER TO CARRY!!!