Dietary, Medical & Asthma Info Check September

1st September 2026

Dear Families,

Dietary, Medical & Asthma Information Check - please read carefully

Children with NO Dietary, Medical or Asthma Needs - NO action required!
If your child does not have any dietary, medical or asthma needs, please ignore this request for information, as no action is required. If this changes at any point please contact the school office.

Children with Individual Healthcare Plans
If your child has a medical need that we are aware of that requires an Individual Healthcare Plan (e.g. Diabetes, Cystic Fibrosis, Epilepsy) please ignore this request for information as you will be sent an Individual Healthcare Plan to complete separately. If you believe your child should have an Individual Healthcare Plan but you don't receive one, please complete the information below to request one or contact the school office.

Children with any Dietary, Minor Medical or Asthma Needs: ACTION REQUIRED by Thursday 3 September
If your child does have a dietary, minor medical or asthma need, it is essential that you complete the form below each year to provide us with up-to-date information. This enables us to continue supporting your child appropriately and meet any needs they may have.

You only need to answer the questions that are relevant to your child.

The information you provide will be added to your child's school record as soon as possible and will be visible to you in Edulink One under Medical Info.

Children Requiring Medication in School
Please bring any medication required by your child on the first day of term to the school office. All medication must be clearly named and in date.

Children Requiring an Inhaler in School
Please provide an inhaler and spacer in a named, clear container to your child's class teacher on their first day if it is to remain in school. If your child will be taking their inhaler home each day, it should remain in their school bag. Please indicate this on the form below.

We would greatly appreciate it if you could complete this form before the children return to school on Thursday 3 September.

Kind regards

The Dunalley School Team

1. YOUR CHILD

Legal Forename:
Legal Surname:

2. Pupil details:

My child has a dietary need (go to question 3)
My child has a minor medical need (go to question 8)
My child has asthma (go to question 8)
My child no longer has the dietary, medical or asthma need previously shared with school (give details below and go to question 14). You can check your child's information in Edulink One under MEDICAL INFO.

Please give details of the dietary, medical or asthma need they NO LONGER have

3. Is the Dietary Need:

Medically Certified Allergy / Condition
Medically Certified Allergy / Condition and requires an Epipen or Antihistamine in school
An Intolerance
Life Choice
Religious Observation

If a Medically Certified Allergy / Condition - Please supply evidence

4. Please identify Allergens:

Please give full details of Allergen:

5. Please identify Allergens - GLUTEN:

Please give full details of Allergen:

6. Please identify Allergens - NUTS:

Please give full details of Allergen:

7. Please identify OTHER Dietary Needs:

For information - (school fish: fish fingers / battered pollock / tuna mayo)

Please give full details of Dietary Need:

8. Is the Medical Need:

Please give full details of Medical Need:

9. Asthma

	Please select
Diagnosis	Diagnosis Please select

10. Asthma Action Plan

My child has been issued with an Asthma Action Plan by their healthcare professional.
My child has not been issued with an Asthma Action Plan by their healthcare professional.

11. Inhalers in School

	Storage
Inhaler in School	Inhaler in School Storage

12. My child has a working, in-date inhaler, spacer if required, clearly labelled with their name at school in their classroom. Please provide details:

	Inhaler 1
Name of Medication	Name of Medication Inhaler 1
Dose	Dose Inhaler 1
Method of Administration	Method of Administration Inhaler 1
When taken	When taken Inhaler 1
Side effects	Side effects Inhaler 1
Expiry Date	Expiry Date Inhaler 1

13. In the event of my child displaying symptoms of asthma and their inhaler is not available or is unusable, I consent for them to receive Salbutamol from the emergency inhaler held in school.

14. Inhaler Administration

	Please select
How is the inhaler to be administered	How is the inhaler to be administered Please select

Additional Information about your child's asthma::

15. I certify that all the information I have given about my child's is correct.

Parent / Carer Name
Relationship
Signed

Dietary, Medical & Asthma Info Check September - 2026

1. YOUR CHILD

2. Pupil details:

3. Is the Dietary Need:

4. Please identify Allergens:

5. Please identify Allergens - GLUTEN:

6. Please identify Allergens - NUTS:

7. Please identify OTHER Dietary Needs: For information - (school fish: fish fingers / battered pollock / tuna mayo)

8. Is the Medical Need:

9. Asthma

10. Asthma Action Plan

11. Inhalers in School

12. My child has a working, in-date inhaler, spacer if required, clearly labelled with their name at school in their classroom. Please provide details:

13. In the event of my child displaying symptoms of asthma and their inhaler is not available or is unusable, I consent for them to receive Salbutamol from the emergency inhaler held in school.

14. Inhaler Administration

15. I certify that all the information I have given about my child's is correct.

7. Please identify OTHER Dietary Needs:

For information - (school fish: fish fingers / battered pollock / tuna mayo)