Student Allergies Form

At Mayfield School, the health and wellbeing of our students are our top priority. As many of our students have complex needs and specific dietary requirements, it is essential that we have the most up-to-date information regarding any allergies.

If your child has an allergy, please complete our Student Allergy Update Form as soon as possible. This information will help us ensure that staff, including our kitchen team, are fully aware of any allergies and can take the necessary precautions.

Please note: This form is only for allergies. If your child has food preferences or dietary choices, please communicate these directly with their class teacher.

Even if your child’s allergy information remains the same, we kindly ask you to confirm their current details to ensure accuracy. If there are any changes throughout the year, please complete the form again as soon as possible so we can update our records accordingly.

Student Allergies Form

"*" indicates required fields

Child's Name*

First Last

Class*

Allergy Information

This form is only for allergies. If your child has food preferences or dietary choices, please communicate these directly with their class teacher.

Does your child have any allergies?*

Yes

What is your child allergic to?*

Please list and provide details of all their allergies

What type of reaction does your child have? (E.g., rash, breathing difficulties, swelling, etc.)*

Has your child been prescribed an EpiPen or any emergency medication?*

Yes

Please provide details of the medication and dosage*

Additional Information

Is there anything else we need to know about managing your child’s allergies at school?

Consent

Name of the person filling out this form*

First Last

Contact Number*

Email*