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EPI-PEN PARENTAL CONSENT FORM KIDS QUEST Please complete one form per child. Please send form to Kid s Quest Day Camp, 2400 Old Crow Canyon Road Suite A4, San Ramon, CA 94583 I give permission to

How to fill out epi-pen parental consent form

How to fill out the epi-pen parental consent form:

1. Start by providing your personal details: Fill out your full name, address, phone number, and email address in the designated spaces on the form.
2. Next, provide the necessary information about your child: Write your child's full name, date of birth, and any known allergies or medical conditions that require the use of an epi-pen.
3. Indicate the school or organization: If the form is being filled out for a school or organization, write the name of the institution and provide any additional required details, such as the grade or class your child is in.
4. Specify emergency contacts: Write down the names, phone numbers, and relationships of the individuals who should be contacted in case of an emergency involving your child.
5. Consent to the administration of the epi-pen: Read the consent statement on the form carefully and sign it to indicate that you authorize the school or organization to administer the epi-pen to your child if necessary. Make sure to date the consent as well.
6. Review and double-check: Before submitting the form, review all the information you have provided to ensure its accuracy. Correct any mistakes, if any, and make sure all required fields are filled out.
7. Return the form: Submit the completed form to the appropriate person or office, following the instructions provided. Keep a copy of the form for your records.

Who needs epi-pen parental consent form:

1. Parents or legal guardians: As the primary caregivers of the child, parents or legal guardians are typically responsible for filling out the epi-pen parental consent form. This form allows them to authorize the administration of the epi-pen to their child in case of an allergic emergency.
2. Schools or educational institutions: Schools often require parents to fill out the epi-pen parental consent form to ensure they have the necessary authorizations on file. This enables school staff to administer the epi-pen promptly if a child experiences a severe allergic reaction while on school premises or during school activities.
3. Organizations or programs involving minors: Outside of schools, other organizations or programs that involve minors may also require parents or legal guardians to complete the epi-pen parental consent form. Examples include summer camps, sports clubs, and childcare centers, where having access to the necessary medical information and permissions is crucial for the safety and well-being of the children involved.

For pdfFiller’s FAQs

What is epi-pen parental consent form?

Epi-pen parental consent form is a document that allows a school or childcare provider to administer an EpiPen to a child in case of an allergic reaction.

Who is required to file epi-pen parental consent form?

Parents or legal guardians of children with severe allergies are required to file the epi-pen parental consent form.

How to fill out epi-pen parental consent form?

To fill out the epi-pen parental consent form, parents need to provide their contact information, child's medical history, details of the allergy, instructions for administering the EpiPen, and sign the form.

What is the purpose of epi-pen parental consent form?

The purpose of the epi-pen parental consent form is to ensure that trained staff can quickly and safely administer an EpiPen to a child experiencing a severe allergic reaction.

What information must be reported on epi-pen parental consent form?

The epi-pen parental consent form must include the child's medical history, details of the allergy, emergency contact information, instructions for administering the EpiPen, and the parent's signature.

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