Report epi-pen administration
Schools must submit a written report to the Department of Public Health each time epinephrine is administered to a student or staff.
Contact for Report epi-pen administration
School Health Services Support
The Details of Report epi-pen administration
How to report Report epi-pen administration
You must report the incident online here.
- This form (and the link) Will change every school year. Please be sure to use the link to the current form.
- Please do not include any names, dates of birth, or other details in this form that might permit someone to identify the person receiving the epinephrine.
- Questions with an asterisk (*) are required. You must complete them in order to submit the form.