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Student Health Services Campus Box 7304 Raleigh, North Carolina 276957304 Phone (919× 5152563 Fax (888× 9724158 Physician Order for Allergy Immunotherapy Please read the information below and sign

How to fill out physician order for allergy

How to fill out a physician order for allergy:

1. Obtain the necessary forms: Begin by obtaining the physician order form for allergies. This can typically be obtained from the healthcare provider or clinic where the patient is receiving treatment.
2. Fill in patient information: Start by filling in the patient's personal information on the form. This includes their full name, date of birth, contact information, and any relevant medical history that may be important for the physician to know.
3. Specify allergy details: Clearly state the specific allergies that the patient has. This may include listing the allergens, such as pollen, dust mites, certain foods, or medications, and specifying the severity of each allergy if known.
4. Outline treatment plan: Provide detailed instructions on how the patient should be treated for their allergies. This can include specific medications to be prescribed, dosages, frequency of administration, and any other relevant instructions such as avoiding allergens or using an allergy action plan.
5. Include emergency contact information: Ensure that the physician order form includes emergency contact information. This may include the name and phone number of a designated emergency contact person who should be notified in case of any allergic reactions or emergencies.

Who needs a physician order for allergies:

1. Patients with severe allergies: Individuals who have severe allergies, especially those that can lead to life-threatening reactions such as anaphylaxis, typically require a physician order. This ensures that proper treatment protocols are followed and that necessary medications are prescribed.
2. Patients undergoing allergy testing: People who are undergoing allergy testing to identify specific allergens may require a physician order. This allows the healthcare professional to administer the appropriate tests and interpret the results accurately.
3. Individuals seeking allergy immunotherapy: For patients interested in allergy immunotherapy, commonly known as allergy shots, a physician order is necessary. This helps the healthcare provider develop a personalized treatment plan and administer the injections safely.

In summary, filling out a physician order for allergies involves providing patient information, specifying the allergies and their severity, outlining the treatment plan, and including emergency contact information. This order is typically required for individuals with severe allergies, those undergoing allergy testing, or those seeking allergy immunotherapy.

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