Allergies & Epinephrine Auto-Injections
Students with an allergy and a history of anaphylaxis, must have an "Allergy and Anaphylaxis Action Plan" on file at the school. This form is completed and signed by a parent/guardian AND a health care provider. Students are allowed to carry or carry and self-administer an epinephrine auto-injector ONLY when appropriate forms have been completed and signed by parent/guardian AND a health care provider.
Please print forms in Color if at all possible.
Once you have completed the form(s) AND they have been appropriately signed, contact the school nurse to schedule a meeting to review the form(s) and discuss your child's allergy. It is especially important that this meeting take place with elementary age students to evaluate the knowledge of their allergy and ability to safely carry or carry and self-administer an epinephrine auto-injector.
The Allergy & Anaphylaxis Action Plan must be reviewed and renewed Annually.
801-794-2226 ext. 218