Food Allergy Advisory Form Food Allergy Advisory Form This form submits to the director of Dining Services, the executive chef at Dining Services, the nutritionist of Dining Services, and the dietician in Health Services. Arrival date to campus* Date Format: MM slash DD slash YYYY Your name* First Last Your email address*A copy of this form will be automatically CC'ed to you. Day Time Phone Number*xxx-xxx-xxxxDescription of your food allergy:*Epi-pen required?yesnoIf yes, do you carry an epi-pen with you at all times?yesnoAdditional follow-up required:Permission to share information*I give Health Services and Dining Services permission to share information about my food allergy.yesno
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