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What is EpiPen Action Plan

The Allergy Action Plan for EpiPen Self-Carry is a medical consent form used by schools to allow students with severe allergies to carry and self-administer an EpiPen.

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EpiPen Action Plan is needed by:
  • Parents or guardians of students with severe allergies
  • School administrators responsible for student health policies
  • Medical professionals certifying a student's ability to use an EpiPen
  • School nurses managing student health records
  • Teachers involved in student care during school activities
  • Coaches supervising students in sports or outdoor activities

How to fill out the EpiPen Action Plan

  1. 1.
    Begin by accessing pdfFiller and searching for 'Allergy Action Plan for EpiPen Self-Carry'. Open the form in your browser.
  2. 2.
    Once the form is open, familiarize yourself with the sections that need to be filled out, paying attention to fields for the student's name, allergies, and emergency contacts.
  3. 3.
    Gather necessary information including the student's medical history, specific allergies, and the physician's details who will certify the student's readiness to self-administer the EpiPen.
  4. 4.
    Using pdfFiller's interface, click on the text fields to type in the required information. Ensure accuracy as this information will be crucial in emergencies.
  5. 5.
    Use the checkboxes to indicate allergies and any required actions for both minor and major allergic reactions. Refer to any attached medical guidance to fill out these sections correctly.
  6. 6.
    After completing the details, review the entire form for any missing or incorrect information. Make sure that the signatures from the parent/guardian and doctor are included.
  7. 7.
    Once you have double-checked the form, save your work by clicking the save button. You can download the completed form in your preferred format directly from pdfFiller.
  8. 8.
    To submit the form, follow your school's specific submission guidelines which may include uploading the document or sending it via email. Ensure it reaches the appropriate school official.
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FAQs

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This form is intended for students with severe allergies who have been trained to use an EpiPen. It requires signatures from both a parent/guardian and a doctor responsible for the student's health.
While specific deadlines may vary by school or district, it is recommended to submit the Allergy Action Plan before the start of the school year or immediately after a diagnosis of severe allergies.
The completed form can usually be submitted via email or by handing it directly to the school nurse or administrator. Check your school’s policy for specific submission methods.
Typically, a physician's note certifying the student’s ability to use the EpiPen may be required along with the completed action plan. Always verify specific requirements with your school.
Ensure all required fields are filled accurately, including allergy details and signatures. Double-check for typos or incomplete sections, as these can delay processing and emergency responses.
Processing times can vary but generally, once submitted, it may take a few days for school officials to review and approve the form. Follow up with your school if there are any delays.
Immediate updates to the Allergy Action Plan are necessary if there are changes in the student’s allergies or treatment. Contact your school to modify the existing form accordingly.
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