Complete this incident report if epinephrine was administered on a school campus. If the incident occurred at a location other than on a school campus, please contact LifeReach at 1-844-548-4968.
This form collects general information regarding the anaphylactic incident. No personal health information is needed to answer questions. All questions purposely avoid collecting personal health information.
The report includes 52 multiple choice questions and will take approximately 10 minutes to complete. The report should be completed in its entirety in one session. The report cannot be saved and finished later.