ࡱ> BDA{ \"bjbjzz .*l <tFLm<$$ #EmmC777777V`K Y0xS$6S$S$D77S$ : Grade Teacher SCHOOL HEALTH EMERGENCY PLAN School Year  FORMTEXT  2012-2013 Student Name: Birth Date Physician: Parents/Guardians: Phone: Phone Other Contact: Phone:  FORMTEXT       Condition: Asthma  FORMTEXT       Other Pertinent Info: Allergies: Brief Background: Current Health: Medication: 1. IF THIS HAPPENS: 1. States needs inhaler 2. Wheezing, coughing 3. Difficulty breathing, and shortness of breath DO THIS: 1. Stop activity, sit student down, take slow deep breaths 2. Give the following medication immediately  FORMTEXT       Student carries Medication in office Use 15 minutes prior to PE 3. Have student rest and observe 4. May return to class if symptoms have improved JKs~  " 3 6 ? I Q { | } ׶į}jhHUhDhc>*hDhH>* hcCJhDhB'>*hDhchQ hZX5\jhH5U\jhH5U\hDhH\ hH5\ h 9{5\ hD5\ hHCJ hDCJhd.hH,K! " | } > $IfgdZX $Ifgd 9{$If$a$gd 9{gd 9{$a$$a$ < > b j l  2 4 L N X Z \ ~ _ ` j k   ž|vvkiUjhHU hHCJhH5CJ\hHCJaJ h 9{5\ jhH5U\mHnHujhH5U\jhH5U\ hH5\hDhHCJ\aJhchHCJhHjhHUmHnHujhHUjthHU) z$If $Ifgd 9{ukd`$$Ifl40* ` 0644 laf4  2 4 _kd$$Ifl*+0644 la $Ifgd 9{ukd$$Ifl40* 0644 laf44 L N X Z \ ~ ; _kd $$Ifl*+0644 la$If .X^` & F$If$If_kd$$Ifl*+0644 la 5. May offer sips of tepid water OTHER INFORMATION: CALL 911/Notify parent if student has any of the following symptoms: DO NOT LEAVE CHILD ALONE Difficulty walking, talking, hunched over, blue lips and fingernails Neck and chest muscles pulled in, struggling to breathe Unresponsive  _______________________________________ ________________________________________ Nurse's Signature Date Parent's/Guardian's Signature Date \^`bHVN P h l n p \"hH56>*\] hH5\hHCJaJ hHCJhH56>*CJ\]hH`bHVP j l & F$If$If_kdz$$Ifl*+0644 lal n p 6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA D Default Paragraph FontVi@V 0 Table Normal :V 44 la (k ( 0No List PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] l* \"  4 `l \" 1=ClFtFtFtFt8@0(  B S  ?Text3Text16Text18Text232nDnnn3JK~  36QQuu{{@AVVjj}}1Dkn)[xNc+ 6_>HbxN^`5CJOJPJQJ^Jo(^`.pp^p`.h@ @ ^@ `5CJOJPJQJ^Jo(^`.^`.^`.^`.PP^P`.h^`CJOJQJo(qh ^`OJQJo(oh pp^p`OJQJo(h @ @ ^@ `OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h ^`OJQJo(oh PP^P`OJQJo(^`5CJOJPJQJ^Jo(^`.pp^p`.@ @ ^@ `5CJOJPJQJ^Jo(^`.^`.^`.^`.PP^P`.)[>Hb )[c+ bX50 M   M               M   M       TB'Oh 9{HQZXcd.Dln@@>>l@ @UnknownG* Times New Roman5Symbol3. * Arial;Wingdings?= * Courier NewA$BCambria Math"1h<G<Gt Q Q !20iiKQHX  $PZX2!xx 'Grade ________ Teacher _______________ Windows98 Andrea Landis   Oh+'0 4@ ` l x (Grade ________ Teacher _______________ Windows98 Normal.dotmAndrea Landis2Microsoft Office Word@F#@@HK@HKQ՜.+,0 hp  ƷSMӰƬ i (Grade ________ Teacher _______________ Title  !"#$%&'()*+,-./02345678:;<=>?@CRoot Entry Fp"KEData 1Tablek$WordDocument.*SummaryInformation(1DocumentSummaryInformation89CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q