Consent form for emergency Salbutamol Inhaler

Child showing symptoms of asthma /having an asthma attack

Pupil Name
DD slash MM slash YYYY
I can confirm that my child has been diagnosed with asthma and has been prescribed an inhaler(Required)
My child has a working in-date inhaler, clearly labelled with her name, which she will bring with her to school every day(Required)
In the event of my child displaying symptoms of asthma, and if her inhaler is not available or is unusable, I consent for my child to receive Salbutamol from an emergency inhaler held by the school for such emergencies(Required)
DD slash MM slash YYYY

Data Protection: Talbot Heath School Trust Ltd, as a Registered Data user, has an obligation to comply with the principles of the Data Protection Act 1998. Any personal details collected on this form will only be used for the purpose(s) stated. This information will be kept securely and will not be passed on to any third parties without the data subject’s consent. Information will not be kept longer than is necessary. Any queries regarding Data Protection should be sent to the Headmistress.

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