PACNJ Asthma Treatment Plan    En Español

What is an Asthma Treatment (Action) Plan?
It is a written plan prepared by your Health Care Provider to
control your asthma.

Your Asthma Treatment Plan tells you:

• What medicine to take
• How much medicine to take
• When to take your medicine
• What to do in an emergency
• What things trigger your asthma –
  like dust, mold, pets, odors

For Parents of Children with Asthma
New Jersey Law requires students with asthma to have an
Asthma Treatment Plan on file with the School Nurse.

The PACNJ Asthma Treatment Plan is the only written plan approved by the New Jersey Department of Health and Senior Services as meeting the requirements of the New Jersey Law.

For students to carry their inhaler in school, your Health Care Provider must check off approval at thebottom of the PACNJ Asthma Treatment Plan.

Print the PACNJ Asthma Treatment Plan
Print the PACNJ Asthma Treatment Plan to discuss with your Health Care Provider and take a signed copy to the school nurse.

Physician Task Force
Promotes statewide use of the PACNJ Asthma Treatment Plan and the NHLBI guidelines for the diagnosis and management of asthma.

Co-Chair
Arthur Torre, MD
Pediatric Allergist
www.arthurjtorremd.com

Co-Chair
Roberto Nachajon, MD
Pediatric Pulmonology
St. Joseph's Children's Hospital

SAVE AND PRINT
the Fillable PACNJ
Asthma Treatment Plan

English Fillable/Savable Form - Color
English Fillable/Savable Form - B & W

Spanish Fillable/Savable Form - Color

English/Spanish Fillable Form - Color
English/Spanish Fillable Form - B & W

(fill in the English section of the plan and the Spanish version will be completed simultaneously)
 
Fillable/Savable PDF Printing instructions -For optimal printing results do the following:

1. Before downloading the plan, save one of the "fillable/savable" treatment plans above to your computer by right clicking on the file name and choosing "Save Target As".

2. After saving the Plan as a file on your computer, open it and choose one of the options below found on the bottom of the English Treatment Plan:

- Click on the "Print only selected Medicines" button and only the medications you have selected will print along with anything else you have completed on the plan
OR
- Click on the "Print" button and all of the medications listed will print (including those you have selected) and anything else you have completed on the plan.

For assistance using these new fillable/savable PDFs or to give us your feedback please email info@pacnj.org.

Updated Credits for 2011-2012
The Pediatric/Adult Asthma Coalition of New Jersey is sponsored by the American Lung Association in New Jersey. This publication was supported by a grant from the New Jersey Department of Health and Senior Services, with funds provided by the U.S. Centers for Disease Control and Prevention under Cooperative Agreement 5U59EH000491-03.  Its content are solely the responsibility of the authors and do not necessarily represent the official views of the New Jersey Department of Health and Senior Services or the U.S. Centers for Disease Control and Prevention.  Although this document has been funded wholly or in part by the United States Environmental Protection Agency under Agreement XA97250908-4 to the American Lung Association in New Jersey, it has not gone through the Agency’s publications review process and therefore, may not necessarily reflect the views of the Agency and no official endorsement should be inferred. Information in this publication is not intended to diagnose health problems or take the place of medical advice. For asthma or any medical condition, seek medical advice from your child’s or your health care professional.

Disclaimer
The Pediatric Asthma Coalition of New Jersey (PACNJ), disclaims any responsibility for any action taken by viewers as a result of their interpretation of information provided. Viewers are encouraged to discuss medical treatment with their physician. The Pediatric Asthma Coalition of New Jersey is sponsored by the American Lung Association of the Mid-Atlantic (ALAM-A), a nonprofit organization.

Inclusion in this website does not necessarily constitute an endorsement, nor does exclusion necessarily indicate disapproval by the Pediatric Asthma Coalition of New Jersey and/or the American Lung Association of the Mid-Atlantic.

The Pediatric Asthma Coalition of New Jersey is not responsible for information, advice, or results related to implementation of said information/advice, provided by any PACNJ member agencies or individual representing said member agencies.