Food Allergy Plan and Medication Packet

Food allergies which may require the use of Epinephrine and/or Benadryl require the following forms to be filled out by both the child's physician and the parent and returned to the school nurse. A Food allergy plan includes the Food Allergy and Anaphylaxsis Emergency Care Plan, Emergency Health Care Plan, Request for Emergency Administration of Epinephrine form, 2 medication order forms- one for Epinephrine and one for Bendaryl, and an optional parent updated health history of your child's allergy including any changes from year to year, class trip and party information and if he or she will need to sit at the designated peanut free table in the cafeteria

Forms links below:

Food Allergy and Anaphylaxsis Emergency Care Plan

Individual Emergency Health Care Plan

Request for Emergency Administration of Epinephrine

Medication Administration Form (Please Print two copies one for Epi and one for Benadryl)

Optional Parent Updated Food Allergy Form