Anaphylaxis Emergency Plan
An anaphylaxis emergency plan is an important tool to share with teachers and caregivers. It lists a person’s allergies, the signs and symptoms to watch for, and the emergency procedure to follow.
- Anaphylaxis Emergency Plan with EpiPen® instructions
- Plan d’urgence pour l’anaphylaxie et feuille d’instructions pour EpiPenMD
(1) The Anaphylaxis Emergency Plan is a fillable form. You can download, fill in and save your information OR print a copy and add your information by hand.
If you are using it as a fillable form, remember to download and save the file first before entering information. Do not complete the form within your browser as information will not be saved.
(2) You can use Adobe Acrobat to add an image (.jpeg, .png, etc.) or Adobe Acrobat Reader to add an image (.pdf only) to the “PHOTO” box of the Anaphylaxis Emergency Plan.
To do so, please follow the instructions related to the Adobe software version you are using. Alternatively, you can print the completed form and attach a photo to this box.
Source: Anaphylaxis in Schools & Other Settings, 3rd Edition Revised