A NOTE FROM THE REAGAN CLINIC REGARDING STUDENTS WITH SEVERE ALLERGY NEEDS / MEDICATIONS:

Listed below is the paperwork needed for your student to have anaphylaxis medication at school for next school year.  We are sending this packet in case your student has doctor appointments this summer during which time these forms can be completed.  Please click the form name to access and completed it.

• Please complete the “Severe Allergy Emergency Care Plan” (Allergy Form 2). Attach a recent picture of your student. This form should be signed by the physician and the parent.
• For all students that will be carrying their medication, the “Authorization to Carry and Self-Administer Prescription Anaphylaxis Medicine” (Allergy Form 3) needs to be reviewed and signed by both parent and student. Anaphylaxis injections (ie EPI-PENS) and inhalers are the ONLY medications allowed to be carried by students.
• If carrying EPI-PENS, please fill out the top portion of the “Criteria for Students with Authorization to Carry Self-Administer Prescribed Anaphylaxis Medicine” (Allergy Form 4).
• We encourage students to have permission to carry their anaphylaxis medication in the event of a field trip or before or after school hour activities. If your student is not carrying anaphylaxis medications and you have left some in the clinic please notify the clinic at least 3 days in advance if you would like for us to provide the medication for a field trip.
• If your child is to carry their anaphylaxis medication, we do encourage you to leave extra anaphylaxis medication in the clinic in case of an emergency.

If you have any questions, please do not hesitate to contact us at (210) 356-1859 or email us at gheyla@neisd.net or pgonza24@neisd.net  FAX (210) 482-2222

Thank you!

Gigi Heyland Franklin, RN | Pam Gonzalez, LVN | Rose Mata, CA

ALL EMERGENCY MEDICATONS MUST HAVE NEW PAPERWORK & BE RELABELED EACH YEAR IN ORDER TO CARRY!!!