
Get the free Food Allergy Action Plan - dcisd.org
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DENVER CITY ISD Kelley/Dodson Student Health Services, Telephone: (806) 5926072 FAX: (806) 5925929GRAVITT/HS Student Health Services (806) 5925956 (806) 5925949For CN Office purposes only: Date received:
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How to fill out food allergy action plan

How to fill out food allergy action plan
01
To fill out a food allergy action plan, follow these steps:
02
- Obtain a copy of the food allergy action plan form from a healthcare provider or school nurse.
03
- Write the name and contact information of the person with the food allergy at the top of the form.
04
- Fill out the medical history section, providing details about the food allergy, any known triggers, and previous reactions.
05
- List any prescribed medications or emergency treatments for the food allergy and their dosages.
06
- Include the contact information for the person's healthcare provider.
07
- Specify any accommodations or special instructions for managing the food allergy, such as avoiding certain foods or environments.
08
- Sign and date the form, ensuring all necessary parties also sign, such as the healthcare provider and parent or guardian.
09
- Make copies of the completed form and distribute them to relevant individuals, such as school staff, caregivers, or coaches.
10
- Keep a copy of the food allergy action plan easily accessible in case of emergencies.
Who needs food allergy action plan?
01
Anyone with a food allergy needs a food allergy action plan.
02
This includes both children and adults who have been diagnosed with a food allergy.
03
Food allergy action plans are especially important for individuals who are at risk of severe allergic reactions, known as anaphylaxis.
04
This may include individuals with a history of severe allergic reactions, multiple food allergies, or other underlying medical conditions.
05
Schools, childcare facilities, and other institutions often require students or participants with food allergies to have a documented food allergy action plan.
06
However, it is recommended for anyone with a food allergy to have a food allergy action plan in place to ensure their safety and appropriate management of allergic reactions.
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What is food allergy action plan?
A food allergy action plan is a written document that outlines steps to be taken in case of an allergic reaction to food.
Who is required to file food allergy action plan?
Schools and childcare facilities are typically required to have a food allergy action plan on file.
How to fill out food allergy action plan?
A food allergy action plan can be filled out by including information about the individual's allergies, symptoms, emergency contact information, and instructions for treatment.
What is the purpose of food allergy action plan?
The purpose of a food allergy action plan is to ensure the safety of individuals with food allergies by providing guidance on how to respond to allergic reactions.
What information must be reported on food allergy action plan?
Information that must be reported on a food allergy action plan includes the individual's name, allergies, symptoms of allergic reactions, emergency contact information, and steps for treatment.
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