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Asthma & Inhaler Users

Parental Permission to use School Emergency Inhaler

This form is for all students diagnosed with Asthma or who may require occasional use of an Inhaler

If your child is not in this category then please do not complete this form.

As you may be already aware, the school has an emergency Asthma Inhaler kit which includes an Inhaler (Blue - Salbutamol) and disposable spacers.

If your child uses an Inhaler (even if you do not keep a spare inhaler in the school office), please would you complete this form which gives you the option to consent (or not) for the school to use the emergency Inhaler should your child’s Inhaler not be available or working in an emergency situation.

(You may have completed a consent form last year but we would like to update this on an annual basis.)

If you have any queries, please do not hesitate to contact apassey@agsb.co.uk
Which school year is your child currently in?*
I can confirm that my child has been diagnosed with Asthma and has been prescribed an Inhaler:*
My child has a working, in-date Inhaler clearly labelled with their name, which they will bring with them to school everyday:*
In the event of my child displaying symptoms of Asthma (or other related breathing difficulties detailed above), and if their Inhaler is not available or is unusable, I consent for my child to receive Salbutamol from an Emergency Inhaler pack held by the school for such emergencies:*