By definition, self-administration/self-possession means that the student is able to apply a metered dose inhaler or dry powdered inhaler to alleviate their asthmatic symptoms, or an epinephrine auto-injector or epinephrine inhaler to treat anaphylaxis (a severe allergic reaction that can range from mild to life-threatening with symptoms that include itchy hives, swelling of the lips, tongue, or eyes; throat swelling; nausea and vomiting; and wheezing and difficulty breathing) in the same manner directed by his/her physician witout any additional assistance or direction.

Self-possession means, that under the direction of the physiciain, the student may carry medication on his/her person to allow for immediate and self-determined administraiton. In order to self-administer medication, all of the following criteria must be met:

• The student has written approval to possess and use the inhaler or epinephrine auto-injector from the student's physician or other health care provider authorized by law to prescribe an inhaler or epinephrine auto-injector and, from the student's parent/legal guardian.
• There is on file in the school office a written emergency care plan that contains specific instructions for the pupil's needs that is prepared by a physician licensed in this state in collaboration with the student and the student's parent/legal guardian, and that is updated as necessary for changing circumstances. 

 

My signature below gives my consent for my student to be allowed to self-administer the above medication at school according the school policy.