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Allergy Action Form - Mundelein Coop Preschool 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the student's name and birth date in the designated fields at the top of the form.
- Indicate any allergies by filling in the 'ALLERGIC TO' section, and provide the Epi-Pen expiration date.
- Specify if the student is asthmatic by checking 'Yes' or 'No'. If yes, note if they are at high risk for severe reactions.
- Review the signs of an allergic reaction listed on the form. This will help you identify symptoms quickly.
- For minor reactions, fill in the symptoms and medication/dose to be administered, along with emergency contact information for parents and doctor.
- For major reactions, clearly state suspected ingestion symptoms and medication/dose to be given immediately. Ensure to call 9-1-1 as instructed.
- Finally, sign and date both parent’s and doctor’s signature sections to complete the form.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2015 | 4.8 Satisfied (58 Votes) |
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