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Food Allergy Form
Parent Name
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Please type the name of parent who filled this form. Thank you.
Parent Email
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Child's Name
*
Grade
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Select
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Please list all foods to which your child is allergic to:
Please list all medications to which your child is allergic to:
Describe your child's reaction to the allergens above:
Does your child carry an Epi-pen?
Yes
No
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