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Asthma Self Carry ContractSchool: Grade: STUDENT : DOB: I plan to keep my rescue inhaler with me at school rather than in the school health office. I agree to use my rescue inhaler responsibly, in
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How to fill out asthma self-carry contract

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How to fill out asthma self-carry contract

01
Step 1: Obtain the asthma self-carry contract form from your healthcare provider.
02
Step 2: Review the form and make sure you understand all the terms and conditions.
03
Step 3: Fill in your personal information, such as name, date of birth, and contact details.
04
Step 4: Provide information about your asthma condition, including any triggers, symptoms, and emergency contacts.
05
Step 5: Indicate the medications you carry for asthma self-management and provide details of dosage and administration.
06
Step 6: Sign and date the contract to acknowledge your agreement with the terms and responsibilities.
07
Step 7: Make a copy of the completed contract for your records.
08
Step 8: Submit the filled-out contract to your healthcare provider for review and approval.
09
Step 9: Keep a copy of the approved contract with you at all times in case of emergencies.

Who needs asthma self-carry contract?

01
Anyone with asthma can benefit from having an asthma self-carry contract.
02
This contract is especially recommended for individuals who frequently experience asthma symptoms or have a history of severe asthma attacks.
03
It is also beneficial for individuals who regularly carry asthma medications with them for immediate use.
04
Schools, workplaces, and other organizations may also require individuals with asthma to have a completed asthma self-carry contract on file.
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Asthma self-carry contract is a document that allows students with asthma to carry their inhaler or other asthma medication with them at school.
Students with asthma who need to carry their medication at school are required to file asthma self-carry contract.
To fill out asthma self-carry contract, students or their parents/guardians need to provide their personal information, doctor's information, medication details, and sign the contract.
The purpose of asthma self-carry contract is to ensure that students with asthma have access to their medication at all times in case of an asthma attack.
The asthma self-carry contract must include student's name, date of birth, emergency contact information, doctor's name and contact information, medication details, and signatures.
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