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Parents of Children with Known Allergies Requiring Medication(s) From: Our Lady of the Assumption Catholic School Clinic The nurses in the OLACS clinic take your child’s health and safety very seriously. Therefore, it is important that you take the time to update and renew all required allergy forms, so we may take the appropriate action for your child if/when it may be necessary. Per Archdiocesan regulations, Allergy Action Plans and Medication Permits must be submitted to the clinic each year. Both
forms require a physician’s signature, and must be dated after June 1, 2012. Once the Plan is completed, the
parent/guardian, student, school nurse, and a representative of the school administration must meet to review the plan.
The following need to be returned to the clinic no later than July 30, 2012:
1. Allergy Action Plan (with required Physician signature) 2. Medication Permit Form (with required Physician signature) 3. Parent Waiver/Food Allergy Policy (food allergy only) 4. The required medication(s) named on the signed Medication Permit Form. Any medication that your child may need to take as part of the Allergy Action Plan must be labeled with the child’s name and
brought by the parent to the clinic office no later than July 30, 2012. If a student’s medication is not in the clinic by
Wednesday, August 8, 2012, the student will not be allowed to attend classes.
The clinic requires that any child who requires Benadryl ™ as part of an Allergy Action Plan must provide either the “fast-melt
tabs” or “strips.” Liquid Benadryl™ will not be accepted.
Below is information regarding the allergy policies of the Archdiocese of Atlanta and Our Lady of the Assumption Catholic School. Allergy Action Plan
An Allergy Action Plan is required for food allergies as well as any allergy requiring medication should a reaction occur (bee
sting, etc.)
Epi‐Pens
The State of Georgia has a law in place regarding the use of epi‐pens in schools. The complete law can be found at
http://www.legis.state.ga.us/legis/2009_10/fulltext/sb8.htm.
If you choose to have your child carry his/her epi‐pen during school hours, the school must have written permission from your child’s physician stating that the child may carry his/her epi‐pen along with the signed Archdiocese of Atlanta Medication Permit Form. Additionally, students who carry the epi‐pen on their person must have a second epi‐pen stored in the school clinic. If the child self‐administers the epi‐pen, he/she must alert school personnel/the clinic immediately and 911 will be called. Food Allergies
A copy of the Archdiocesan Food Allergy Guidelines is enclosed. Per this policy, each student with a food allergy must have an
Allergy Action Plan on file with the clinic.
The school nurses appreciate your cooperation in supporting them to keep your child(ren) safe. Sincerely, Jenny Brysacz, R.N. Amie Calderon, R.N. Kerry May, R.N.

Source: http://www.olaschool.org/wp-content/uploads/2013/05/medication-policy-memo1.pdf