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Medication Asthma

Before completing this form you must agree that all medication given by the staff at Bonneygrove and Millbrook Primary Federation l is done so with 'loco parentis responsibility'. Please indicate you agree by clicking the box below.*
Is your child's asthma - please select one.*
Does your child have disrupted sleep due to his/her asthma? PLEASE SELECT ONE.
How many times (if any) has your child attended the accident and emergency (A&E) department with an acute asthma attack in the past year?
Who monitors your child's asthma?
How often is your child seen by the Hospita/ GP/ Nurse?*
What inhalers / medications has your child been prescribed?*
Can the family GP be contacted should we need additional information?*
Does your child need their reliever/ inhaler before PE?
How many pumps do they need?*
Does your child need support taking their inhaler?*
Does your child have a clear understanding on how to use their inhaler?*
Does your child require a spacer for their inhaler?*
In the event of my displaying symptoms of asthma, and if their inhaler is not available or unavailable, I consent for my child to receive salbutamol from an emergency inhaler held by the school for emergencies.*
Does your child attend Kool KIdz?*
Parent / Carer signature. By clicking 'yes' you agree to the terms of the asthma medical policy.*