Free Food Allergy List Template
Food Allergy List for Emergency Situations
|
Prepared by |
[Your Name] |
[Your Company Name] |
Last Updated |
[Date] |
This list serves as an emergency guide detailing common food allergens and appropriate responses in case of an allergic reaction. It includes the location and usage instructions for an Epinephrine Auto-Injector, emergency contacts, and relevant medical history. It is crucial to regularly update and communicate these details for swift response during emergencies.
Common Allergens
|
Allergen |
Severity Level |
Additional Information |
|---|---|---|
|
Peanuts |
High |
May cause severe allergic reactions |
|
Tree Nuts |
Moderate |
Avoidance recommended, mild reactions possible |
|
Milk/Dairy |
Low |
Lactose intolerant, mild discomfort |
|
Eggs |
Moderate |
Allergic reactions, consult a doctor |
|
Soy |
Low |
Minimal impact on allergic individuals |
|
Wheat |
High |
Celiac disease, strict gluten-free diet required |
|
Fish |
Moderate |
Allergic reactions, use caution |
|
Shellfish |
High |
Severe allergic reactions, avoid completely |
Emergency Response
|
Response Type |
Details |
Notes |
|---|---|---|
|
Epinephrine Auto-Injector |
In backpack, administers 0.3mg dosage |
Keep updated, check expiration |
|
Emergency Contacts |
Primary: John Doe (555-1234), Secondary: Jane Smith (555-5678) |
Notify primary first, then secondary |
|
Medical History |
Allergic to penicillin, previous surgeries: appendectomy |
Regular check-ups, update as needed |
Additional Reminders:
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Ensure this list is easily accessible in case of emergencies.
-
Update the information regularly to reflect any changes.
-
Communicate your allergies with close contacts for additional support.
-
Review emergency procedures with those regularly around you.
