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Free template · Health and safety

Allergy alert roster

One page listing every child with an allergy, the signs of a reaction, what to do and where their medicine is, so any staff member can act fast.

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What's in it

What the allergy roster covers

At the top: Keep this roster with the group, including on field trips and during drills. It contains private health information, so post it only where staff can see it, not families or visitors. Update it whenever a family tells you something has changed.

Group

  • Program and group
  • Lead staff and phone
  • Last updated (date and by whom)

Children with allergies

Table: Child (add a photo if you can) · Allergies · Signs of a reaction · What to do · Where medicine is · Parent phone

In an emergency

  • Follow the child's allergy action plan from their doctor.
  • For a severe reaction, use the child's epinephrine auto-injector if they have one and call 911 right away.
  • Stay with the child and send someone for the medicine, this roster and the child's medical form.
  • Call the parent or guardian, then the director.
  • Fill out an incident report the same day.

Free to use and change, but not legal or medical advice. Check your state's licensing rules and your insurer's requirements, and have a lawyer review any consent or waiver language.

Tips

How to use it well

  • Copy the details from each child's medical and allergy form, and ask families for their doctor's allergy action plan.
  • Make sure every staff member, substitute and volunteer knows where the roster and the medicines are.
  • Bring the roster and medicines on field trips, swim days and drills.
  • Post it where only staff look, such as inside a kitchen cabinet door or in the group's binder.

Rules on ratios, medication and reporting vary by state. See your state in our state-by-state rules for youth programs.

FAQ

Questions, answered

Is it OK to post a list of children's allergies?

Staff need to see it fast, but it's private health information. Post it where only staff look, such as inside a cabinet door or in the group's binder, and ask families how they'd like it handled. Check your state's licensing rules, since some require allergy information to be posted in certain places.

What should an allergy roster include?

Each child's name and photo, what they're allergic to, the signs of a reaction, what to do, where their medicine is and how to reach their parent. Keep it to one page so a substitute can use it in an emergency.

More free templates

Authorized pickup formLists every adult allowed to pick a child up and anyone who isn't, with the program's pickup rules. Keep a copy with each roster.
Medical and allergy formCollects the allergy, medication and medical details staff need, plus emergency contacts and consent for emergency care.
Incident and accident reportA staff form for recording injuries, illnesses and behavior incidents the same day: what happened, first aid given, who was told and what you'll change.
Medication administration logRecords every dose of medicine staff give a child: date, time, dose, who gave it and any reaction. Use one log per child, per medicine.
Emergency action planA fill-in emergency plan for fire, severe weather, lockdown, a missing child, medical emergencies and reunification, with blanks for your site's details.
All templates28 free forms, logs, policies and plans for camps, after-school programs and classes, as PDF and Word files: registration, pickup, medical and more.

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