Allergy Medication

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Allergy Medication

Child's full name *

Aerius consent *

I hereby authorise the staff of Allegro Child Care Centre Ltd. to administer Aerius to my child upon a clear notice of an allergic reaction. I also agree that with accordance of this agreement I will follow up with a doctor’s visit. The staff of Allegro Child Care Centre Ltd. agree to call the parent or emergency contact person before any medicine is given.

Required

Claritin consent *

I hereby authorise the staff of Allegro Child Care Centre Ltd. to administer Clairtin to my child upon a clear notice of an allergic reaction. I also agree that with accordance of this agreement I will come follow up with a doctor’s visit. The staff of Allegro Child Care Centre Ltd. agree to call the parent or emergency contact person before any medicine is given.

Required

Benadryl consent *

I hereby authorise the staff of Allegro Child Care Centre Ltd. to administer Benadryl to my child upon a clear notice of an allergic reaction. I also agree that with accordance of this agreement I will follow up with a doctor’s visit. The staff of Allegro Child Care Centre Ltd. agree to call the parent or emergency contact person before any medicine is given.

Required

Epi-pen consent (if required)

If this is checked, please visit the office and fill out an anaphylaxis action plan

I hereby authorise the staff of Allegro Child Care Centre Ltd. to administer Epi-pen to my child upon a clear notice of an allergic reaction. The staff of Allegro Child Care Centre Ltd. agree to call 911 immediately followed by the parent or emergency contact person.

Parent's signature *

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