Required Reporting Forms

Facilities that adopt an unassigned epinephrine auto-injector, opioid antagonist, and/or asthma medication policy must report when they administer the medication to any adult or child. This reporting is required to comply with the respective Texas Administrative Code. Facilities include schools, day care facilities, sports venues or other entities. 

Reports must be submitted to DSHS and respective entities no later than 10 business days after the medication is administered.

Asthma Medication

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

Report 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

Schools - Report Unassigned Administered Epinephrine Auto-Injectors to DSHS

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 - Report Unassigned Administered Epinephrine Auto-Injectors to DSHS

Epinephrine Auto-injectors: Certain Entities

• Amusement parks
• Restaurants
• Sports venues

Certain Entity or Venue - Report Unassigned Administered Epinephrine Auto-Injectors to DSHS

Opioid Antagonists

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

Report Administered Opioid Antagonist Medication to DSHS

Asthma and Anaphylaxis-related Resources 

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

• School Asthma Action Plan
• Metered Dose Inhaler Administrative Guideline
• Possible Problem List for Meter Dose Inhaler
• Benefits and Risk Management Checklist
• Sources for MDI
• Unassigned Epinephrine Anaphylaxis Protocol
• Severe Allergic Reaction - Anaphylaxis Protocol
• Your Rights Under Section 504 of the Rehabilitation Act [pdf] 
• Managing Students With Health Issues: Section 504 Plans, DNR Orders, and Contagious Diseases [pdf]