Food Allergen Management Form

Facility Name Contact Person Date

Product Name Batch Number

Allergen Checklist

Allergen	Present in product
Eggs
Milk
Fish
Peanuts
Soy
Tree Nuts
Wheat
Shellfish
Other (specify)

Controls and Procedures

Describe allergen control procedures (e.g., cleaning, storage, cross-contact prevention) Describe product labeling procedures (including allergen statements)

Verification & Review

Reviewed By Review Date