School Bus Food Allergy Safety Plan

Student Information

Student Name Grade Bus Number / Route

Parent/Guardian Contact Information

Name(s) Phone Number(s) Email

Allergy Details

Allergy to (list foods or substances) Type of Reaction/Severity

Emergency Action

Signs/Symptoms of an Allergic Reaction Emergency Medication (e.g., EpiPen location & instructions) Steps to Take in Case of Exposure

Emergency Contacts (Name & Number)

Bus Safety Procedures

Additional Notes