Skip to content ↓

AAI Form

Parental Permission to use School Emergency Adrenaline Auto Injector (AAI) Kit

This may be an EpiPen, Jext or other AAI brand

Which school year is your child currently in?*
I can confirm that my child has been diagnosed as being at risk of anaphylaxis and has been prescribed an adrenaline auto injector (AAI).*
My child has a working, in-date AAI, clearly labelled with their name, which they will bring with them to school every day.*
In the event of my child displaying symptoms of anaphylaxis, and if their AAI is not available or is unusable, I consent for my child to receive adrenaline from an Emergency AAI held by the school for such emergencies.*