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Dosage forms / Medical equipment / Peak expiratory flow / Inhaler / Nebulizer / Medicine / Respiratory therapy / Asthma


Dear Parent/Guardian, If your child has asthma that may require treatment at school please fill out the following paperwork. This will give us the necessary information and authorization to treat your child. Please bring
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Document Date: 2014-10-15 14:51:49


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IndustryTerm

school health care services / School-related health services / health services / /

MedicalCondition

injury / own asthma / cough / upper respiratory illness / severe asthma / Gastroesophageal reflux / asthma / /

Organization

School Staff’s administration / Groesbeck Independent School District / Self Administration / /

Person

Guardian / Jenny Flowers / /

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Position

physician / Phone_____________________ Physician / Teacher / school nurse / registered nurse / /

Product

Administer Asthma Medication / /

SocialTag