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Making an Agreement With Your Child

Our Asthma Agreement

You want your child to be healthy. Your child wants the same thing. Working together makes the odds of success very high. Consider making a written promise to work on good asthma control. You can use the one below or make your own.

We agree to the following:

You can be healthy and strong and still be a kid with asthma. Together we will eat healthy, exercise, and get plenty of sleep.

Together, we will talk to the doctor about your asthma and the best medicines for you to take. We will ask your doctor to create an Asthma Action Plan that works for our family.

We will use the Asthma Action Plan so that we know:

  • What your triggers are
  • When to take control medicine
  • How to respond to worsening symptoms
  • What to do during a breathing emergency

Together, we will learn to recognize your warnings signs, and follow your Asthma Action Plan to take the necessary steps to keep your asthma in good control.

We will identify your triggers and make a plan to avoid or limit them to keep your asthma in good control.

If you have warning signs, tell me or another adult right away so we can check with your Asthma Action Plan for what to do. If you are at school, tell your teacher or another adult. If you are at a friend’s house, tell the friend’s parents. Asthma can be dangerous. That is why you need to tell me or another adult right away when you have warning signs.

After you tell an adult about your warning signs, you should take your quick-relief medicine. This is your inhaler. We can ask someone at the doctor’s office to show you the best way to use the inhaler. You might need help from an adult to take your quick-relief medicine.

After you take your quick-relief medicine, you should sit down and rest so you can feel better and so the medicine can work. Remember not to lie down so the medicine can get to your lungs.

A good thing to do after you take your quick-relief medicine is belly breathing. We will learn how to do that together. The steps are:

  1. Sit up straight in a chair.
  2. Place both hands on your belly.
  3. Breathe in slowly through your nose. Pretend you’re filling up your belly with air. Feel it blow up big like a balloon. Keep your chest still.
  4. Blow the air slowly out of your mouth, through puckered lips. Feel your belly get small.
  5. Repeat this slowly 5 to 10 times.

We are a team, and together we will work hard to keep your asthma in good control so you can be as healthy and active as you want to be.

Parent signature_____________________________________

Child signature______________________________________

Our Asthma Agreement

Asthma Triggers
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Learn how controlling triggers can reduce your child’s asthma symptoms.

Asthma Action Plan
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Use this convenient form to help manage your child’s asthma.

Medicine Quiz
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Take this quiz to get answers about your child's asthma medicines.