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Food Allergy Form

Proactively manage food allergies with a mobile app

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What is a Food Allergy Form?

A food allergy form is used for early recognition and management of allergic reactions to food. This is used by facilities involved in regularly serving food to a certain set of people (e.g., schools, daycare centers, etc.) Keeping a record of food allergies can help prevent serious health consequences that can be life-threatening.

Food allergy forms contain the following:

  • Participant information (e.g., participant and guardian name, contact number, etc.)
  • Food allergy (e.g., dairy, soy, eggs, peanuts, fish, etc.)
  • Food intolerance (e.g., gluten, lactose, fructose, histamines, etc.)
  • Dietary needs (e.g., soy butter, gluten free breads, soy milk, etc.)

What is a Food Allergy Action Plan Form?

A food allergy action plan form or a food allergy and anaphylaxis emergency care plan outlines the recommended treatment instructions in case of an allergic reaction. This form is designed to help non-medically trained personnel to perform the appropriate treatment for severe allergic reactions like anaphylaxis in the event of an emergency.

Elements of a Food Allergy Action Plan Form

There is no cure for food allergies and intolerances, but you can avoid life-threatening situations caused by allergic reactions by fostering a proactive approach with the use of a food allergy action plan form.

Below are 5 elements that should be found in a food allergy action plan form:

  1. Criteria
    A symptoms criteria will help the person responsible for treatment to identify the type of allergic reaction, whether it is: mild, moderate, or severe. This will determine which treatment instructions will be most appropriate to effectively manage the allergic reaction.
  2. Medications and dosages
    Create a fillable section to identify brand and dosage of epinephrine and antihistamine given to the participant with allergic reactions.
  3. Treatment instructions
    A good food allergy action plan form should include instructions on how to recognize anaphylaxis and demonstrate how to give a life saving epinephrine.
  4. Required signatures
    The allergy action plan form should be signed by a physician and the parent/guardian if the participant is a minor, otherwise the patient will sign it to verify the information provided in the form.
  5. Emergency contacts
    Emergency contacts are comprised of (but is not limited to) a rescue squad, doctor, parent/guardian or any other relative. After treating the participant, the emergency contacts provided in the form will be contacted.

Better Recordkeeping With a Mobile App

Mitigate the risks of losing important paperwork and keep all food allergy forms secure in one place. Access them whenever, wherever using your mobile or tablet device. Equip your organization with a reliable recordkeeping tool like iAuditor by SafetyCulture. Download and customize ready-to-use food allergy forms or easily create your own via Smart Forms. Keep food allergy records up-to-date even when you’re offline. All records will automatically sync to the cloud once you go back online.


Jai Andales

SafetyCulture staff writer

Jai is a content writer for SafetyCulture based in Manila. She has been writing well-researched articles about health and safety topics since 2018. She is passionate about empowering businesses to utilize technology in building a culture of safety and quality.