ASTHMA PLAN 2024-25

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ASTHMA PLAN 2024-25

Schools are required to hold an Asthma Plan for every child with an asthma diagnosis. This plan details their medication and treatment and should be reviewed and updated annually. Parents should be aware of the need to contact their child's GP at least once a year to review their child's asthma medication and treatment plan. Please also ensure that your child's medicine is in date and that you check expiry dates regularly.

You do not need to complete this form if your child does not have an asthma diagnosis.

Medical information is stored electronically and in hard copy. It is confidential and will normally only be accessed by the School Nurse. However, as the safety and wellbeing of your child is paramount, certain information may need to be shared with selected School staff or other health care professionals.

If there is any information you wish to remain confidential or any aspect of your child's health you would like to discuss, please inform the School Nurse via the Care Centre on 01372 473701 or email carecentre@claremont.surrey.sch.uk.

It is essential in the below email address box that you type the correct email address. We require your email address to act as verification.

If you have more than one child at Claremont Fan Court School, please complete this form once for each child. At the end of this form, you will have the opportunity to start the form again for any other children you have at Claremont. You cannot save your form progress and come back to it at a later stage.

You can see the School’s privacy policy here: https://www.claremontfancourt.co.uk/about-us/our-policies/

Please complete with as much detail as possible.

Email *

Pupil's first name *

Pupil's surname *

Pupil's date of birth (DD/MM/YYYY) *

Address *

Parent/carer's name *

Telephone (home) *

Telephone (mobile) *

Medical Practice Address and Postcode *

Reliever treatment when needed

For shortness of breath, sudden tightness in the chest, wheeze or cough, my child takes the medicines below. After treatment and as soon as they feel better they can return to normal activity.

Medicine prescribed and carried by my child:

CONSENT *

In the event of shortness of breath, chest tightness, wheeze or cough, I DO CONSENT for staff to help or allow my child to take the medicines listed above.

In the event of shortness of breath, chest tightness, wheeze or cough, I DO NOT CONSENT for staff to help or allow my child to take the medicines listed above.

Required

CONSENT

The school Care Centre holds a central reliever inhaler and spacer for use in emergencies. I give permission for my child to use this.

I DO CONSENT for my child to use a central reliever inhaler

I DO NOT CONSENT for my child to use a central reliever inhaler

What signs can indicate that your child is having an asthma attack? *

Does your child tell you when they need medicine? *

Yes

Does your child need help taking their medicine? *

Yes

What are your child's triggers (things that make their asthma worse). Please select all that apply. *

Pollen

Exercise

Cold/flu

Stress

Weather

Air pollution

Other (please list in NOTES section at the end of this document)

Required

Does your child need to take any other asthma medicines while in the school's care? *

Yes

NOTES

Please use this section to tell us any further information that you think we should know about your child's asthma.

By typing your name below and submitting this form, you agree that all the information is correct to the best of your knowledge and that you will update the Care Centre of any changes to this information as it occurs.

*

A copy of your responses will be emailed to the address you provided.

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