Use of Emergency Salbutamol Inhaler

CONSENT FORM - Child showing symptoms of asthma / having asthma attack

1. I can confirm that my child:*
2. My child has a working, in-date inhaler clearly labelled with their name which they will keep in school*
3. In the event of my child displaying symptoms of asthma, and if their inhaler is not available or is unusable, I consent for my child to receive salbutamol from an emergency inhaler held by the school for such emergencies.*
Class*

Please type the letters and numbers displayed in the image into the textbox below to verify you wish to send this response. If you have difficulties reading the letters in the image below you can try a different image by clicking on it.

Verification Image