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Severe Allergies & Anaphylaxis Health Intake Form REV. 8312020Students Name:DOB://Grade:Name of physician treating students allergies:Today's Date://Phone Number:Medical alert jewelry worn? Yes No

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How to fill out school allergy health intake

01

Obtain the school allergy health intake form from the school office or website.

02

Fill in the student's personal information such as name, date of birth, and contact information.

03

Provide details of the student's allergies including specific triggers, reactions, and severity.

04

List any medications the student is currently taking for their allergies.

05

Include emergency contact information in case of a severe allergic reaction.

06

Sign and date the form to confirm completion and understanding of the information provided.

Who needs school allergy health intake?

01

Any student attending school who has allergies should fill out a school allergy health intake form. This form helps school staff be aware of the student's allergies and how to respond in case of an allergic reaction.

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What is school allergy health intake?

School allergy health intake is a form or document that gathers information about students' allergies and health conditions in a school setting.

Who is required to file school allergy health intake?

Students or their guardians are required to file school allergy health intake.

How to fill out school allergy health intake?

School allergy health intake can be filled out by providing details about student's allergies, medications, emergency contacts, and any health conditions.

What is the purpose of school allergy health intake?

The purpose of school allergy health intake is to ensure the safety and well-being of students with allergies by providing necessary information to school staff.

What information must be reported on school allergy health intake?

Information such as student's allergies, medications, emergency contacts, and any health conditions must be reported on school allergy health intake.

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