Keller ISD Health Services Department 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the student's name and date of birth (DOB) in the designated fields at the top of the form.
3. Fill in the teacher's name and grade, followed by emergency contact information for two individuals. Ensure that all contact numbers are accurate.
4. Specify the physician treating the allergy and preferred hospital, along with their contact numbers.
5. Indicate whether the allergy is life-threatening by selecting 'YES' or 'NO'. Provide details about any symptoms exhibited during past reactions.
6. List any foods that cause extreme reactions and confirm if an Epi-Pen will be provided. If yes, remember to attach a prescription.
7. Complete medication details for allergies to be administered at school, including dosage and route.
8. Ensure a physician completes their section, including severe symptoms and emergency procedures.
9. Finally, gather signatures from parents, teachers, and nursing staff as required before submitting the form.

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