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ILLINOIS FOOD ALLERGY EMERGENCY ACTION PLAN AND TREATMENT AUTHORIZATION NAME:D.O.B:TEACHER:GRADE:/Child's Photograph/ALLERGY TO: Asthma: Yes (higher risk for a severe reaction)No Weight: lbs ANY SEVERE
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How to fill out the Illinois food allergy emergency form:

01
Begin by obtaining the Illinois food allergy emergency form. You can usually find it on the Illinois Department of Public Health's website or obtain a copy from your child's school or healthcare provider.
02
Read the instructions carefully to ensure you understand the purpose and requirements of the form.
03
Provide your personal information, including your name, address, phone number, and email address. This information is crucial for contact purposes in case of an emergency.
04
Fill in the details of the person who has the food allergy. Include their name, date of birth, and any relevant medical information.
05
Indicate the specific food or allergen that triggers the allergic reaction. Be as specific as possible to ensure proper precautions are taken.
06
Specify the symptoms or reactions that occur when exposed to the allergen. This information helps medical professionals understand the severity of the allergy.
07
Include any additional instructions or emergency protocols that should be followed in case of an allergic reaction.
08
If necessary, provide a list of medications or treatments that should be administered during an allergic reaction. This may include the use of epinephrine auto-injectors (such as an EpiPen).
09
Sign and date the form, indicating that the information provided is accurate and up-to-date.

Who needs the Illinois food allergy emergency form?

01
Individuals with food allergies who are at risk of experiencing severe allergic reactions.
02
Students attending schools or daycare centers in Illinois, as schools often require parents to submit this form to ensure proper care and emergency preparedness for students with food allergies.
03
Any individual who wishes to have an emergency plan on file with their healthcare provider in case of accidental exposure to allergens.
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Illinois food allergy emergency is a reporting requirement for schools in Illinois to track and manage students with food allergies.
Schools in Illinois are required to file Illinois food allergy emergency.
Illinois food allergy emergency form can be filled out online or submitted through the designated channels provided by the Illinois Department of Public Health.
The purpose of Illinois food allergy emergency is to ensure the safety and well-being of students with food allergies while at school.
Information such as student's name, grade, specific food allergies, emergency contact information, and any required medical treatment plans must be reported on Illinois food allergy emergency form.
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