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Food Allergy Assessment Form Student Name: Date of Birth: Date: Parent/Guardian: Phone: Cell/work: Health Care Provider (name) treating food allergy: Phone: ? No Do you think your child?s food allergy.

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IF ANY ONE (OR MORE) OF THESE SIGNS ABOVE ARE PRESENT: Lie child flat with legs raised (if breathing is difficult, allow child to sit) Immediately dial 999 for ambulance and say ANAPHYLAXIS (“ANA-FIL-AX-IS”) ... the SPARE AUTOINJECTOR if available. ... Stay with child until ambulance arrives, do NOT stand child up.

A student with diagnosed anaphylaxis or mild to moderate allergic reactions should have an Action Plan completed by their medical practitioner.

Children with an ASCIA Action Plan (red or green) should have an individualised anaphylaxis care plan. These plans may have a different name in different jurisdictions. Regardless of the name of the plan, the purpose is the same.

An anaphylaxis risk management plan helps to identify areas of potential risk and possible solutions to reduce the risk. Anaphylaxis risk management plans should be developed for day-to-day allergy management at the children's education and care service.

ASCIA Action Plans are medical documents that are completed and signed by the treating doctor or nurse practitioner. A signature is sufficient, ASCIA Action Plans do NOT need to be stamped. To insert a digital photograph and signature, first save as a PDF after typing patient details into the text fields.

Call 911. Tell emergency dispatcher the person is having anaphylaxis and may need epinephrine when emergency responders arrive. Consider giving additional medications following epinephrine: » Antihistamine » Inhaler (bronchodilator) if wheezing • Lay the person flat, raise legs and keep warm.

Q 4: Can schools or parents complete an ASCIA Action Plan for their students or children? No. ASCIA Action Plans have been developed as medical documents and must be completed, signed and dated by the patient's doctor or nurse practitioner.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232