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Use of School Auto-injector Consent form
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Email *
Student's Name *
Date of Birth *
Tutor Group *
I consent to my child being given Anti-Histamine (the age appropriate dose) in the case of an allergic reaction *
I consent to my child using the school auto-injector (Epi-Pen 0.3mg) in an emergency *
Any other information we should know
Name of person giving permission *
Date *
MM
/
DD
/
YYYY
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