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PLACE PICTURE Rename: D.O.B.: Allergy to: Weight: lbs. Asthma: Yes (higher risk for a severe reaction) None: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction.
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Extremely reactive materials are chemicals that can react violently with air or water.
Any facility or individual that handles or stores extremely reactive materials may be required to file this form.
The form typically requires information about the specific extremely reactive materials being stored or used, storage location, quantity, safety measures in place, and emergency response procedures.
The purpose of the form is to ensure that proper safety measures are in place for handling extremely reactive materials and to provide emergency responders with important information in case of an incident.
Information such as the identity and quantity of the reactive materials, storage location, safety measures, and emergency contact information must be reported.
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