LATEX ALLERGY IHP

Changes/Updates?

I welcome any and all suggestions regarding the wording of this IHP.  Please contact me via this Contact Form to share your thoughts, comments, or need for additional choices.  Thank you in advance!

All the best, Cyndi

Student's Name *
Accepted file types: jpg, gif, png, jpeg, Max. file size: 100 MB.

DoB
Would you like to add the student's ID number?
Would you like to add the student's homeroom number and teacher's name?

Address
Emergency Contact List is attached to IHP.

Treating Physician
Physician Phone Number
Physician Fax Number
Add More

Add a medication or procedure?

Nursing Diagnosis: Potential for severe allergic reaction and/or life threatening episode
Nursing Diagnosis: Potential for change in medical status
Nursing Diagnosis: Potential for altered health maintenance
Would you like to add another nursing diagnosis?

IHP Developed By

Name
Date
Do you want to include physician and parent signature lines?
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