KS HKS Severe Allergies Anaphylaxis Health free printable template

Healthy Kansas SchoolsSevere Allergies & Anaphylaxis Health Intake Form 1 of 2NOTE: Parents are to provide the physicians medical management plan to the school annually. The medical orders, along

How to fill out KS HKS Severe Allergies Anaphylaxis Health

How to fill out KS HKS Severe Allergies & Anaphylaxis –

1. Begin by writing the student's full name at the top of the form.
2. Include the student's date of birth and grade level.
3. List all known allergies, specifying the type of allergen (e.g., food, medication, insect stings).
4. For each allergy, indicate the severity and describe the specific symptoms that may occur in case of exposure.
5. Note any history of anaphylaxis related to the allergies listed.
6. Provide emergency contact information for the parents or guardians.
7. Include specific instructions for managing an allergic reaction, including any medications that need to be administered (e.g., EpiPen).
8. Sign and date the form to verify that the information provided is accurate.

Who needs KS HKS Severe Allergies & Anaphylaxis –?

1. Any student with known severe allergies or a history of anaphylaxis needs to fill out the KS HKS Severe Allergies & Anaphylaxis form.
2. Parents or guardians of children who have documented allergies that could lead to severe reactions should complete this form to ensure appropriate care.
3. It is also beneficial for staff members who will be responsible for the child's safety and health to have access to this information.

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What is KS HKS Severe Allergies & Anaphylaxis?

KS HKS Severe Allergies & Anaphylaxis is a form used to document severe allergies and potential anaphylaxis reactions that individuals may experience, particularly in healthcare and educational settings.

Who is required to file KS HKS Severe Allergies & Anaphylaxis?

Individuals with known severe allergies, their guardians or caregivers, school personnel, and healthcare providers are typically required to file KS HKS Severe Allergies & Anaphylaxis to ensure proper management and response in case of allergic reactions.

How to fill out KS HKS Severe Allergies & Anaphylaxis?

To fill out KS HKS Severe Allergies & Anaphylaxis, one must provide detailed information regarding the individual's allergies, including the specific allergens, severity of reactions, emergency procedures, and any prescribed medications.

What is the purpose of KS HKS Severe Allergies & Anaphylaxis?

The purpose of KS HKS Severe Allergies & Anaphylaxis is to ensure that all relevant personnel are informed about an individual's severe allergies and to establish a clear protocol for emergency situations involving anaphylaxis.

What information must be reported on KS HKS Severe Allergies & Anaphylaxis?

Information that must be reported on KS HKS Severe Allergies & Anaphylaxis includes the individual's name, specific allergies, severity of past reactions, treatment protocols, emergency contact information, and any medications that may be necessary.