Allergy Action Plan
If your child has a severe allergy that might require the use of Epinephrine or Benadryl please download the form below, have your PHYSICIAN complete and sign it and return the form to the school nurse.
If your child will be carrying and self-administering his/her Epinephrine PEN the Epinephrine Self-Administration Form must be completed and your child must demonstrate competency to the school nurse.
For the forms below, click on the image that appears to open the full document.
Self Administration of Asthma Inhaler/Epinephrine Auto-Injector/Diabetes Medication
Severe Allergy Action Plan (English)
Severe Allergy Action Plan (Spanish)