Required Reporting Forms

People who work in settings such as schools, day care facilities, and sports venues, must report when they give asthma medication or epinephrine to any adult or child.  

Report no later than 10 business days after the medication was given.  

 

Asthma medication  

  • School districts 
  • Open-enrollment charter schools 
  • Private schools 

 

ADMINISTERED UNASSIGNED ASTHMA MEDICATION TO DSHS 

 

View asthma and anaphylaxis related resources.

 

Epinephrine auto-injectors: K-12

  • School districts
  • Open-enrollment charter schools
  • Private schools
  • Institutions of higher education

K-12 REPORTING  

Epinephrine auto-injectors: Youth facilities 

  • Child-care facilities
  • Day/youth camps
  • Youth centers
  • Small employer-based day-care facilities
  • Temporary shelter day-care facilities
  • Listed family homes
  • Any other private or public entity that would benefit from the possession and administration of epinephrine auto-injectors, that provides services for youth under the age of 18

YOUTH FACILITIES  

Epinephrine auto-injectors: Certain entities

  • Amusement parks
  • Restaurants
  • Sports venues

CERTAIN ENTITIES  

Asthma and anaphylaxis-related resources 

(All items below are Word documents unless noted otherwise.)