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Many of the Clearinghouse materials can be viewed and printed by clicking the images or the item numbers.

Asthma Action Plan
For health care professionals only. Triplicate form, when completed by health care providers, provides parents and school personnel with written asthma management plans for children. Multicolored and illustrated, the form identifies personal best peak flow, levels of symptom severity, and appropriate patient action. Contains Student Medication Administration Authorization; may also be used for all asthma patients. Developed by the Mass. Health Quality Partners and representatives from 21 Massachusetts health care organizations. 8.5"x11"/ triplicate/

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English (#AS901)
Chinese (#AS906)
Haitian Creole(#AS904)
Khmer(#AS907)
Portuguese(#AS903)
Russian(#AS905)
Spanish(#AS902)
Vietnamese (#AS908)

Adult Asthma Action Plan form


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  For health care professionals only.This duplicate form, when completed between a physician and patient during an office visit, provides an agreed upon treatment plan to help adults manage their asthma. Multicolored and illustrated, the form identifies peak flow levels, levels of asthma care and patient action--from control of long term symptoms and triggers to actions to take for a severe episode of asthma. Developed by Massachusetts Health Quality Partners and representatives from 21 Massachusetts health care organizations. 8.5"x11"/ duplicate/
 

English (#AS911)
Chinese (#AS912)
Haitian Creole(#AS913)
Khmer (#AS914)
Portuguese(#AS915)
Russian(#AS916)
Spanish(#AS917)
Vietnamese (#AS918)
    Adult Asthma Care Card wallet card
    For adults with asthma. This tri-fold card provides adults with an easy way to carry important asthma management information including a list of asthma triggers, asthma related medications and other medications they are taking, as well as steps to take to control asthma symptoms or manage an asthma episode. It includes listings for emergency contacts and health care providers. Developed by Massachusetts Health Quality Partners and representatives from 21 Massachusetts health care organizations. 4.25" x 2.5"/ 3-panel/
    English (#AS921)
Chinese (#AS922)
Haitian Creole(#AS923)
Khmer (#AS924)
Portuguese(#AS925)
Russian(#AS926)
Spanish(#AS927)
Vietnamese (#AS928)