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Anaphylactic Reactions Consent Form

For the administration of medicine/treatment as discussed with the child’s parent or guardian.

Has the child’s details changed since the original Jones Tuition booking? (E.g. new address, new doctor new contact details)

Information about the child's allergy and reactions.

About the Medication that may be required or administered.

In the case of a reaction, Jones Tuition staff will follow the instructions as provided by the parent/guardian in treating the child.

In the case of a severe reaction Jones Tuition staff will adhere to the accident procedure found in the Policies and Procedures Document.

I the Parent/ Guardian have provided the Jones Tuition staff with all of the necessary information required by them to deal with my child’s condition, the symptoms and the actions required in the event of my child suffering an allergic reaction.

It is my responsibility to provide and maintain the appropriate and up to date medication/treatment for my child.

I confirm that the above information is correct and give permission for Jones Tuition staff to administer the medication in the manner stated above.

Thanks for submitting!

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