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Get Canada PWSD76 Student Allergy Form 2012-2024

__________________________________________________ Grade: ___________ This form must be signed by the student’s medical practitioner and parent (or guardian). Please provide the following information: 1. Identify the substance(s) to which the student is known to be allergic to. 2. List the symptoms of the allergic reaction(s). 3. List detailed emergency procedures to be followed in the event of an allergic reaction. 4. If medication is to be administered as part of the emergency procedure, t.

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