As parent/guardian of the above named student, I give my permission to the school nurse and other designated staff to administer medication and follow protocol as identified in the asthma action plan. I agree to release, indemnify, and hld harmless the above from lawsuits, claim expense, demand or action, etc.,against them for helping this student with asthma treatment, provided the personnel are following prescriberinstruction as written in the asthma action plan above. Parent/Guardians and students are responsible for maintaining necessary supplies, medication and equipment. I give permission for communication between the prescribing health care provider, the school nurse, the school medical advisor and schoolbased clinic providers necessary for asthma management and administration of medication. I understand that the information contained in this plan will be shared with school staff on a needtoknow basis and that it is the responsibility of the parent/guardian to notify school staff whenever there is any change in the student’s health status or care.