Use of Emergency AAI pen

Adrenline Auto-Injector (AAI) pen (for example Epi-pen, Jext pen, Emerade pen) for emergency use
Child showing symptoms of allergy and anaphylaxis

Hawthorn Community Primary School has now made arrangements to hold emergency Adrenaline Auto-Injector (AAI) pens for the use of students diagnosed with an allergy whose prescribed AAI pen is not available for any reason in the event of an emergency.

According to our records your child suffers from an allergy and has been prescribed an AAI pen (for example Epi-pen, Jext pen, Emerade pen).

• I can confirm that my child has been diagnosed with an allergy and has been prescribed an AAI pen.*
• My child has two working, in date AAI pens in the school office.*
I give consent for my child to receive Adrenaline from an emergency AAI pen held by the school in the event of my child displaying symptoms of anaphylaxis and if their AAI pens are unavailable or unusable*