Sitter's Guide

Child Age

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__________________ has asthma and takes the following      medications on a regular basis :____________________________

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You may reach me at:   ____________________________________

If you cannot reach me, contact:   ___________________________

Early warning signs are:   _________________________________

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Special instruction if any early signs should develop:   _________

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If he/she should have an asthma flare, remain calm and follow the above instructions.

IN CASE OF EMERGENCY Doctor's Phone #____________________________________       Emergency Room #:__________________________________              Health Insurance:_____________________ ID#:____________