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To complete this form electronically, Life Threatening 2025

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The document is an Allergy Action Plan designed for students with allergies, detailing necessary information about the student, their allergies, and emergency procedures. It includes sections for parent and physician input, medication administration guidelines, monitoring protocols during allergic reactions, and permissions for self-carrying epinephrine. The plan emphasizes the importance of immediate action in case of severe allergic reactions and outlines communication between parents, school staff, and healthcare providers.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the student's legal last and first name, along with their date of birth and grade. This information is crucial for identifying the student.
Fill out the Parent/Guardian Information section. Include names and phone numbers for both guardians to ensure effective communication.
Indicate any allergies by checking the appropriate boxes and providing specifics. This section is vital for ensuring the safety of the student.
Complete the medications section, specifying dosages for epinephrine and antihistamines as recommended by a physician.
Review all sections carefully before submitting to ensure accuracy. Use our platform's features to save your progress if needed.

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