Template for Allergist letter for 504 (notnutty)

[ajasfolks2]

This is just an example of a letter you could use to draft your own letter for the allergist to sign when trying to qualify for a 504


This may be what you received, but I've posted it before(great letter from another member, but I changed it to fit *my* child)...GOOD LUCK!!

To Whom It May Concern:
I have been asked by XX XX's parents to provide medical information regarding XX�s allergies. I understand that you need specific and current information that will be used to determine whether or not XX meets the criteria for a 504 Designation under Section 504 of the Rehabilitation Act of 1973. I believe XX qualifies for this designation based upon his diagnosis and clinical history of life-threatening (anaphylactic) food allergies.
Anaphylaxis is defined as a systemic allergy reaction and can cause death or permanent disability. Approximately 150 people die each year due to anaphylaxis to foods, most commonly to peanuts. Below, I briefly describe the body systems affected during anaphylaxis:

Systems & Symptoms

Skin and subcutaneous tissues: mouth itching and swelling of the lips, tongue, or mouth, and hives.
Gastrointestinal system: nausea, abdominal cramps, vomiting and/or diarrhea (the vomiting and diarrhea can be severe, leading to intravascular volume depletion and shock).
Respiratory system: throat itching and/or sense of tightness in the throat, hoarseness sue to edema in the larynx with the possibility of closure of the airway, hacking cough, shortness of breath, repetitive coughing, and/or wheezing.
Cardiovascular system: "thready" pulse, decreased cardiac function leading to drop in blood pressure and shock, leading to possible cardiac arrest.

XX has a history of rapidly progressing anaphylaxis involving the gastrointestinal, skin, respiratory, and cardiovascular systems. Due to this reaction history, XX is at elevated risk of a fatal anaphylaxis.
XX was diagnosed with life-threatening food allergies at the age of 1 1/2 years. Since that time, he has also been diagnosed with severe, potentially life-threatening allergies to all tree nuts and eggs. (Test results available upon request). XX has a clinical history of reactivity to ingestion of microscopic quantities of allergens, contact with allergens, and inhalation of allergens.
For the purposes of this letter for a Section 504 designation, I attest that XX�s medical condition substantially and significantly affects the life function of caring for one�s self, and may also substantially and significantly limit the life functions of breathing, talking, walking, and performing manual tasks.

There is no cure for food anaphylaxis. Unlike other allergies for which there are medications or immunotherapy, there is no medication, immunotherapy, or device which can act as a mitigating measure for those who are anaphylactic to foods. Regular maintenance medications do not eliminate the need to practice avoidance, nor does epinephrine or any other rescue medication or device necessarily resolve anaphylaxis or eliminate the need to seek additional emergent care. Death or permanent disability is a possible outcome any time anaphylaxis is triggered. Peanut is of particular concern since a triggering dose cannot be reliably determined, even for an individual. Total avoidance is imperative.
Avoidance of all contact with food allergens (peanut, egg, and all tree nuts) is the only way to avoid a potentially life-threatening allergic reaction. Such avoidance is a highly complex task, impossible for a child without the ongoing assistance of an adult who is knowledgeable about the condition. Successful avoidance requires a comprehensive written accommodation plan in consultation with parents and physician.
I consider XX�s parents, XX and XX XX, to be knowledgeable about the successful management of their son�s medical condition.
Sincerely,
Dr. XXX, M.D.


Please change/edit to suit your personal situation.