Getting an Asthma Action Plan and School Medication Form Completed for Your Child

What goes into a school asthma action plan?

An asthma action plan is a written, individualized document — recommended by the National Heart, Lung, and Blood Institute (NHLBI) as part of every asthma patient's self-management strategy — organized into three color-coded zones based on symptoms and, for older children, peak flow meter readings 1Ref 1National Heart, Lung, and Blood Institute (NHLBI) (2020).Asthma Action Plan (2020 edition, aligned with 2020 Focused Updates to the Asthma Management Guidelines).Three-zone (green/yellow/red) asthma action plan structure and the standard template recommended for patients and schools2Ref 2American Lung Association (2024).Create an Asthma Action Plan.Components of a written asthma action plan — triggers, medication names and dosages, color-zone symptom descriptions, and emergency contact information:

• Green zone (controlled asthma): The child when well — no symptoms, breathing normally, able to do all usual activities. Lists any daily controller medication (such as an inhaled corticosteroid) to continue even when symptom-free.
• Yellow zone (caution): Early warning signs such as coughing, mild wheezing, or reduced tolerance for activity. Specifies which rescue inhaler to give, how many puffs, how often, and when to call a parent or guardian.
• Red zone (medical alert): Severe or worsening episode — the child is not responding to the rescue inhaler within 15 to 20 minutes, has difficulty speaking in full sentences, or lips are turning blue. Specifies when to call 911 or go directly to the emergency department.

The clinician fills in the medications, doses, and action steps specific to your child based on their current asthma severity and treatment plan, then signs and dates the form. The parent or guardian also signs. Most schools require this to be renewed annually or whenever medications change 1Ref 1National Heart, Lung, and Blood Institute (NHLBI) (2020).Asthma Action Plan (2020 edition, aligned with 2020 Focused Updates to the Asthma Management Guidelines).Three-zone (green/yellow/red) asthma action plan structure and the standard template recommended for patients and schools.

What is the medication authorization form — and why does it matter separately?

The medication authorization form is the school's legal permission to hold and administer a specific medication on campus. Without a completed and signed medication authorization, the school nurse is typically not permitted to give your child their inhaler during an episode — even in an emergency.

The form includes the medication name, dose, route (inhaled), when it should be given (as needed for symptoms, before exercise, or at a set time), and both clinician and parent signatures. Some states have standardized forms for this purpose; others leave it to the district.

Some states allow students who are mature enough to self-carry and self-administer their rescue inhaler without visiting the nurse's office first. For self-carry authorization, there is often a separate section of the form that both clinician and parent must sign. Most U.S. states have passed laws supporting student self-carry for rescue inhalers — ask the school nurse about your state's specific policy and age requirements.

Which form should you use?

The NHLBI publishes a standard asthma action plan template, updated in 2020 to align with the focused updates to the national asthma management guidelines 1Ref 1National Heart, Lung, and Blood Institute (NHLBI) (2020).Asthma Action Plan (2020 edition, aligned with 2020 Focused Updates to the Asthma Management Guidelines).Three-zone (green/yellow/red) asthma action plan structure and the standard template recommended for patients and schools. The American Lung Association also provides a widely-used template that schools commonly accept 2Ref 2American Lung Association (2024).Create an Asthma Action Plan.Components of a written asthma action plan — triggers, medication names and dosages, color-zone symptom descriptions, and emergency contact information. However, some schools and states have their own required form — and submitting the wrong format can require the clinician to complete the process a second time.

Before scheduling the appointment, ask the school nurse: - Does the school have its own specific asthma action plan form? - Does it accept the NHLBI template? - Does it have a separate medication authorization form, or is it part of the action plan?

Once you have the correct forms, bring them pre-filled with the school's contact information (nurse name, phone number, school address) so the clinician can complete the clinical sections efficiently during the visit.

A 2020 national survey of parents found that 84% of families had asthma action plans available at school, and 78% of parents found them helpful for school management 3Ref 3Pletta KH, Kerr BR, Eickhoff JC, Allen GS, Jain SR, Moreno MA (2020).Pediatric Asthma Action Plans: National Cross-Sectional Online Survey of Parents' Perceptions.84% of families had asthma action plans available at school; 78% of parents found plans helpful for school management; plans beneficial regardless of provider type or family socioeconomic status. Proper completion with the right form and current medication information is what makes the plan genuinely useful when an episode occurs.

When does the plan need to be updated?

Update the asthma action plan and medication authorization form:

• At the start of each school year — even if the medications have not changed. Schools typically require a fresh signature before a new school year begins.
• Any time medications change — a new controller medication, a different rescue inhaler brand or dose, or a new specialist prescription.
• After a hospitalization or emergency department visit for asthma — the treatment plan may have changed significantly.
• If the child's asthma control has worsened or improved — worsening control may move the yellow-zone action step to a stronger dose or more urgent response; good control may allow step-down therapy with updated green-zone instructions.

A mid-year update is entirely appropriate when the clinical picture changes. The school nurse can proactively flag when a plan no longer appears to match the student's actual asthma status.