Allergy & Dietary Record
The allergy or dietary requirement as stated by the parent, where that information came from, what must be avoided, what to do on exposure as written by the parent or on a prescriber's plan, emergency contacts, where any prescribed medication is kept, a review date and the parent's signature. Everything is attributed: the setting records what it was told and by whom. It writes no emergency plan of its own, assesses nothing, and advises nothing — because a plan invented by a childminder is not a plan anyone should be relying on.
Fill & print the form
Runs entirely in your browser — nothing is uploaded; your answers are saved only on this device.
Frequently asked
Why does it ask where the information came from?
Because "mum mentioned it at pickup" and "written on the allergy plan from the clinic" are very different things, and in a hurry nobody remembers which. Attribution and a review date are what keep the record trustworthy.
Can it tell me which foods contain an allergen?
No, and it would be dangerous if it tried. Formulations change without notice. The parent's instructions and the actual ingredient labels govern.