Pennichuck Middle School

SEVERE ALLERGIES AND ASTHMA

• Does your child have a severe allergy or Asthma? In order to ensure the safety of your child, we have medically necessary forms that need to be returned to the nurse prior to the start of EACH new school year.
  • FARE form - Allergy action plan outlined by your child's physician
  • FARE form Spanish
  • Hold Harmless Form(s) for Prescription and/or Over the Counter Medications
  • State of NH Special Dietary Medical Statement (for food allergies only)
  • Asthma Action Plan for Home & School

These forms need to be filled out and submitted to the Pennichuck Nurse’s Office.  It is very important that you contact us about your child’s allergy or asthma, as it can delay treatment if we are not aware of their plan of care. If your child has mild/intermittent asthma but does not have an action plan or medication that they use on a regular basis, please let us know if they carry an inhaler, as we do request to have paperwork on hand and be made aware of students who carry their inhaler.

We respectfully request to be informed of any student who self-carries their inhaler or Epipen.  Doctors’ offices are always happy to provide us with the orders for your child to do so.

Thank you for your cooperation. It is our goal to keep your child safe and healthy!