Summer Fun Asthma Action Plan
Name: _______________________________
Doctor's Name: ____________________ Phone #: ____________
Emergency Contacts
| Name: _________________ |
Telephone: ________________ |
Relationship: _______________ |
|
| Name: _________________ |
Telephone: ________________ |
Relationship: _______________ |
|
Emergency Department
| Hospital/Clinic:___________________________________________________________ |
| Phone #:_____________________ |
| Address:___________________________________________________________ |
| Hospital/Clinic:___________________________________________________________ |
| Phone #:_____________________ |
| Address:___________________________________________________________ |
Pharmacy Information
| Pharmacy Name: _________________________ |
Pharmacy Name: _________________________ |
| Phone #: _________________________ |
Phone #: _________________________ |
Click here for Summer Asthma Action Plan Form in PDF Format
Back-to-School Asthma Action Plan
Getting Ready for Fall: Tips for the New School Year, Fall Allergies, and Asthma
This information has been approved by David Tinkelman, M.D. (February 2006).
Note: This information is provided to you as an educational service of National Jewish Health.
It is not meant to be a substitute for consulting with your own physician.
© Copyright 2008 National Jewish Health
