Haines Home  Mrs. Barbara Caruso Teacher Home
email phone ext. 8534   Nurse's Office Panther since '81
allergy letters & forms asthma medication sheet sports physicals sun, tick, & Lyme info disclaimer

 

 

 

 Allergy Letters and Forms

If your child has a food, bee/insect sting or latex allergy, you will need the following information: 
   
Haines 6th Grade Center-Food Allergy& Epipen letter  
   
Epipen Information Letter for Interscholastic/Intramural/Club Sports
 
Food Allergy Questionnaire ~  Please fill out and return with Anaphylaxis Plan
 
Allergy Questionnaire -not for food  ~ Please use this questionnaire if your child has non food allergies such as bees/wasp/latex
 
Food Allergy Procedures ~ Please keep as a reference
 
Anaphylaxis Individual Emergency Care Plan ~ Please have your physician fill out the form completely and sign the back.  Parent signature is required  on back.