• Please let us know if your child has been diagnosed with a food or other life- threatening allergy by filling out the appropriate forms below and return them to the student’s campus.

  These forms are good for one school year and will need to be resubmitted before the student returns to campus each year.

  If you child’s allergies change at any time throughout the school year, please contact the district Health Services Coordinator.

  Allergy Forms

  The following forms are required to be completed by you and your child’s physician. Please return completed forms to the campus nurse as soon as possible.

  ALL students with known severe food allergies should provide:

  • Food Allergy Emergency Care Plan - Physician’s Signature Required

  • Food Allergy Emergency Care Plan - Physician’s Signature Required (spanish)

  ALL students with other known severe allergies should provide:

  • Anaphylaxis Emergency Action Plan - Physician’s Signature Required

  If your child will need emergency medication at school, you should also provide:

  • A Medication Request form for the prescribed epinephrine auto-injector

  • A Medication Request form for the prescribed antihistamine

  • A Medication Request form for the prescribed inhaler, if applicable

  • The above medication(s), non-expired, and in their original container(s). Prescription medications must have the prescription label attached.

  *Please note that Aubrey ISD will NOT accept a student’s epinephrine auto-injector without a current school year FARE or Anaphylaxis Emergency Action Plan signed by a provider.

  If your child has a severe FOOD allergy that requires a food substitution in the school cafeteria, you will also need to provide:

  • Special Diet Form – Physician Signature Required

More Resources

• For more information on how food and other allergies are managed in the school setting, please see these links:
  
  ❖ GUIDELINES FOR THE CARE OF STUDENTS WITH FOOD ALLERGIES
  
  ❖ TEXAS DEPARTMENT OF STATE AND HEALTH SERVICES