SELF-ADMINISTRATION OF MEDICATION FOR ASTHMA OR SEVERE ALLERGIC REACTION TO FOOD, BEE STINGS OR OTHER POTENTIALLY LIFE-THREATENING ILLNESS IN SCHOOL.
Written authorization for this is required from the Physician and from the parent/guardian annually. The attached forms are provided for this purpose. Please return completed forms for the current school year to the nurse.
IMPORTANT
Your child will NOT be permitted to carry his/her inhaler, nebulizer or epinephrine pen (auto-injector) unless ALL paperwork is completed in full, including physician and parent signatures. These documents include:
ASTHMA ACTION PLAN ( for asthma only)
PHYSICIAN CERTIFICATION FOR STUDENT TO SELF-
ADMINISTER MEDICATION
PARENTAL PERMISSION FOR THE STUDENT TO SELF-ADMINISTER
MEDICATION
These forms have been provided for your convenience. If additional forms are needed, please do not hesitate to contact the Health Office at 973-827-4100 ext.239.