Anaphylaxis Action Plan (Red)

$10.00

Confirm recent attendance.

Action plans can only be ordered online if the patient has attended an appointment with Dr Falk within the last 18 months.

  • Has the patient seen Dr Falk within the last 18 months? *

  • Sorry, it has been too long. *

    You need to have been reviewed by Dr Falk within 18 months to obtain an online action plan.
    Please make an appointment. at your earliest convenience.
  • Patient's Name *

  • Date of Birth (dd/mm/yyyy) *

  • What is the patient's current weight? *

  • Education Level *

  • List the allergens on the existing action plan. *

  • What antihistamine and dose is on the existing action plan? *

  • Does the patient have asthma? *

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SKU: AP002Anaphylaxis Category:

Description

If you need a new action plan without seeing the doctor you can order it here.

However, for action plans, you will need to have consulted with Dr Falk within the last eighteen (18) months.

If you need to arrange a new appointment, follow this link, and ensure you have an up-to-date referral.