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Allergy Action Plan For the 20152016 School Year Students Name: DOB Grade ALLERGY TO: Asthmatic: Yes* No *Higher risk for severe reaction ! STEP 1 TREATMENT Symptoms: If food allergen has been ingested,
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How to fill out allergy action plan for

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How to fill out allergy action plan for:

01
Obtain a copy of the allergy action plan form from your healthcare provider or school nurse.
02
Fill in personal information such as your name, date of birth, and contact information.
03
Include details about your specific allergies, including the substances you are allergic to and any known triggers.
04
Indicate the severity of your allergies, such as mild, moderate, or severe, so that others can understand the appropriate level of action to take.
05
Include a list of emergency contact numbers, including your healthcare provider and any relevant family members or guardians.
06
Specify any medications or treatments that should be administered in case of an allergic reaction, including dosage instructions and potential side effects.
07
Provide detailed instructions on how to recognize the symptoms of an allergic reaction and what steps should be taken to manage the situation.
08
Include any additional information that may be helpful, such as dietary restrictions or specific instructions for certain environments, like school or work.
09
Review the completed allergy action plan with your healthcare provider or school nurse to ensure its accuracy and to address any questions or concerns.
10
Keep a copy of the allergy action plan in a readily accessible location, such as your wallet or backpack, and provide copies to any relevant individuals or organizations, such as school personnel or caregivers.

Who needs allergy action plan for:

01
Individuals with known allergies to substances such as food, medications, insects, or environmental factors should have an allergy action plan.
02
People who have experienced severe allergic reactions in the past, known as anaphylaxis, should always have an allergy action plan in place.
03
Children with allergies attending school or daycare should have an allergy action plan on file with the school nurse and relevant staff members.
04
Individuals who frequently travel or participate in activities where exposure to allergens is possible, such as camping or dining out, should have an allergy action plan to ensure they are prepared for emergencies.
05
Anyone with allergies who may require assistance from others in case of a severe reaction, such as young children or individuals with disabilities, should have an allergy action plan to guide caregivers or emergency responders.
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The allergy action plan is for providing guidance on how to manage and respond to allergic reactions.
Schools, childcare facilities, and other institutions where individuals with allergies may be present are required to have an allergy action plan on file.
To fill out an allergy action plan, you must include information about the individual with allergies, their triggers, symptoms, and emergency contact information.
The purpose of the allergy action plan is to ensure the safety and well-being of individuals with allergies by providing a clear plan of action in case of an allergic reaction.
The allergy action plan must include information such as the individual's name, specific allergies, known triggers, symptoms of an allergic reaction, and emergency contact information.
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