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04/2019GREEN CHARTER SCHOOL
Physician and Parent School Asthma Management Plan
DOB:
Phone:
Physician Phone:Student:
Physician:CUE: With Breathing Difficulties Give Rescue Medicine:
MEDICATION:
DOSE:
Observe
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Fill out the scue form with breathing difficulties by following these steps:
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Start by providing your personal information such as your name, age, and contact details.
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Specify the details of the breathing difficulties you are experiencing. Include information such as the frequency, duration, and severity of the symptoms.
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Mention any triggers or factors that worsen your breathing difficulties, such as physical exertion, allergies, or exposure to smoke or dust.
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Describe any previous medical history related to breathing difficulties, such as asthma, COPD, or allergies.
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Provide information on any current medications or treatments you are undergoing for breathing difficulties.
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Who needs scue with breathing difficulties?
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People who are experiencing breathing difficulties may need to fill out the scue form. This can include individuals with conditions such as asthma, chronic obstructive pulmonary disease (COPD), allergies, or respiratory infections. It is also important for individuals who have recently experienced sudden or severe breathing difficulties or have been exposed to environmental factors that may have triggered respiratory symptoms. The scue form helps healthcare providers assess and evaluate the individual's breathing difficulties and provide appropriate treatment or medical advice.
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