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Page 1 / 6Client Information FormDate://OTPTSTClient Name:OT4Kids ID#: DOB:Address:City:/ State M/Flip:Parent/ Guardians Name: Cell Phone:Home Phone:Work Phone:Email Address: Emergency Contact: Relationship
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How to fill out allergies special diet

01
Identify your specific allergies and dietary restrictions.
02
Consult with a healthcare professional or registered dietitian to develop a personalized special diet plan.
03
Read food labels carefully to identify potential allergens.
04
Avoid consuming any food or ingredient that triggers your allergies.
05
Substitute allergenic foods with suitable alternatives.
06
Plan your meals in advance and prepare homemade meals whenever possible.
07
Inform friends, family, and restaurants about your allergies and specific dietary needs.
08
Carry an allergy emergency kit, including medications and an allergy action plan, in case of accidental exposure.
09
Stay vigilant and continuously educate yourself about potential allergens and hidden sources.
10
Regularly visit your healthcare professional or registered dietitian to monitor your allergies and adjust your special diet plan if needed.

Who needs allergies special diet?

01
People with diagnosed food allergies or intolerances.
02
Individuals who experience adverse reactions after consuming specific foods.
03
Those with medical conditions that require a special diet, such as celiac disease, lactose intolerance, or autoimmune disorders.
04
People who have been advised by their healthcare professional to follow an allergies special diet.
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Allergies special diet is a specific dietary plan designed for individuals with food allergies or intolerances.
Individuals who have allergies or intolerances to certain foods are required to file allergies special diet.
Allergies special diet can be filled out by listing the specific allergens or intolerances, along with alternative food options.
The purpose of allergies special diet is to ensure that individuals with food allergies or intolerances have access to safe and suitable food options.
Information such as specific allergens, intolerances, alternative food options, and any special instructions must be reported on allergies special diet.
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