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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
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How to fill out food allergy action plan

01
Obtain a copy of the food allergy action plan template provided by your healthcare provider.
02
Fill in all personal information including name, date of birth, emergency contact information, and healthcare provider contact information.
03
List all known food allergies and specify the type of reaction that occurs.
04
Detail emergency medication and dosage instructions.
05
Include any additional information or instructions provided by your healthcare provider.
06
Review the completed form with your healthcare provider to ensure accuracy and understanding.

Who needs food allergy action plan?

01
Individuals with known food allergies
02
Individuals at risk of severe allergic reactions
03
Children with food allergies attending school or daycare
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A food allergy action plan is a document that outlines specific instructions on how to manage and treat a person's food allergy in case of an allergic reaction.
Schools, daycare centers, and other facilities that serve food to individuals with food allergies are required to have and file a food allergy action plan.
Food allergy action plans should be filled out by healthcare professionals, in collaboration with the individual with the food allergy and their caregivers. It should include details about the specific food allergens, symptoms, and steps to take in case of an allergic reaction.
The purpose of a food allergy action plan is to ensure that individuals with food allergies receive prompt and appropriate treatment in case of an allergic reaction, to potentially prevent severe health complications.
A food allergy action plan should include details about the individual's specific food allergens, symptoms of an allergic reaction, emergency contact information, and steps to take in case of an allergic reaction.
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