Collection of PHYSICIAN LETTERs used to obtain a 504 Designation: Post yours please!

Posted on: Mon, 03/06/2006 - 2:24am
Gail W's picture
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There are several very good allergist/pediatrician letters posted under Schools. Some have their own threads and others are buried within threads. I thought it may be helpful to collect them in one location so that they are more easily accessible and so that we can look at them for comparison... and learn. Please feel free to post or cut/paste your letter here.

Gail

Posted on: Mon, 03/06/2006 - 2:48am
Gail W's picture
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From here: [url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001875.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001875.html[/url]
______________________________________________________
Dr. xxxx
Director of Instructional Resources
xxx School District
May 9, 2005
To Whom It May Concern:
I have been asked by Mariah X's parents to provide medical information regarding Mariah

Posted on: Mon, 03/06/2006 - 2:52am
Gail W's picture
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Rhonda RS's letter from here: [url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/000431.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/000431.html[/url]
________________________________________________________
(Current Date)
(Mother's Name)
(Father's Name)
Patient: (Child's Name): (Date of Birth)
(Home Street Address)
(Town, State, Zip Code)
Telephone: (telephone number)
E-Mail: (parent's e-mail address)
Dear Dr. (Doctor's Last Name),
(We wrote a personal note thanking him/her for working with us and our child and all the help sh/e has given us thus far.)
We are getting ready to send (the child's first name) to (preschool or public school), and want to have (him/her) in place an accommodation plan that addresses his/her safety needs. To achieve this goal, we need a letter from you stating the circumstances surrounding (Child's Name) allergies. This letter will entitle us to important educational meetings. I am asking for a lot of specific information so that the school can really understand the nature of (Child's Name) allergies and the seriousness of (Child's name) peanut allergy. Could you please discuss the following topics? We greatly appreciate your assistance.
1. Could you please address the letter to (Formal Name of the School District) Administrators, School Nurses and Teachers.
2. (Child's) full name and date of birth.
3. Date of allergy testing.
4. List of allergies confirmed.
5. Other medical conditions: ex. Asthma.
6. Type of reaction your (Child) has to allergy, contact, inhalation, ingestion of the allergen.
*7. *Life Systems that are affected by (the child's) allergic reaction: These life systems include: Cardiovascular, digestive, respiratory and skin. *This topic is extremely important. It is especially important to state that anaphylaxis affects the "life system of breathing is affected."
8. Medical Treatment for allergic reactions.
List medicines that must be present with (Child) at all times.
9. List all medicines that (Child) is currently taking.
10. List medical devices that must be present with (Child) at all times (ex. Nebulizer & Albuterol or inhaler).
11. List other devices or medical aids that (Child) needs (ex. hepafilter, creams, etc.).
12. State that my husband and I are knowledgeable individuals who understand our child's condition and his/her safety needs.
Could you please mail the letter to us directly? We will make copies and keep it on file at our home.
In closing, thank you so much for all your help Dr. (Name of the Doctor). We appreciate your support. The documentation that you provide will help us tremendously in attaining our goal of providing (Name of the Child) with a safe and rich public school experience.
Sincerely,
(Name of both of the Parent)
_________________________________________________________

Posted on: Mon, 03/06/2006 - 3:00am
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School District:
I have been asked by XX

Posted on: Mon, 03/06/2006 - 3:03am
qdebbie1's picture
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Dear School District
X (DOB) is a patient with X Asthma and Allergy Center. It has been brought to my attention that the district is planning to continue serving peanut products in the cafeteria. I was unaware of cafeteria procedures when I signed off on the plan agreeing to eliminate peanut products only from the main menu.
*****this is when the school sent a proposed plan to my doctor and had him sign it and then said see dr x likes it...nice try******
As stated in my previous letter, X requires a safe learning environment in all classrooms, cafeteria and all shared facilities. Strict avoidance of the allergen is the only way to allow him to fully participate in all school activities. In order to reasonably accommodate this student

Posted on: Mon, 03/06/2006 - 3:04am
Gail W's picture
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Corvallis Mom's letter from here: [url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/002166.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/002166.html[/url]
______________________________________________________
To Whom It May Concern:
I have been asked by XXXXX XXXXX's parents to provide medical information regarding XXXXXX

Posted on: Mon, 03/06/2006 - 3:11am
qdebbie1's picture
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Dear School District:
X X () is a patient with the X Asthma and Allergy Center under my direct care. He has been diagnosed with a life threatening peanut allergy. His test results are the highest level making his allergy extremely severe. X also has a history of anaphylactic reactions. This impairment will produce similar or worse reactions in the future. Any exposure to peanut products by ingestion, touch, or smell can cause a reaction that would quickly endanger his major life activity of breathing, possibly resulting in death.
X requires a safe learning environment in all classrooms, cafeteria, and all shared facilities. Strict avoidance of the allergen is the only way to allow him to fully participate in all school activities.
All teachers and staff involved with his education should be made aware of this condition and properly trained to handle emergency situations.
Please contact the office if you need further information.
Sincerely,
X, MD
X Asthma and Allergy Center
x0x-3xx 23x5

Posted on: Mon, 03/06/2006 - 3:14am
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what a great idea.
you may notice I took some wording from other letters to create my own.
Sorry they are out of order, I thought it was such a good idea I jumped right in.
The last post is the first letter sent to the school. Then the next letter and the pediatrician letter. I also had a letter from his original allergist in ohio but it was more of a form letter version and not as helpful. And a letter from his Nurse practioner but the district said her opinion was invalid. That definately worked in my favor because she didnt like that comment, she lives in the district and was happy to have the pediatrician write anything help.
In total I had 2 letterst from his current allergist
1 from the allergist who did the testing
1 from a np( not on file)
1 from pediatrician.
My consent form only gave permission to talk with the allergist and they never called that I know of, only that tricky tactic at the beginning.
anyone is free to use all/any part of my letters.

Posted on: Mon, 03/06/2006 - 7:05am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Quote:Originally posted by qdebbie1:
[b]what a great idea.
you may notice I took some wording from other letters to create my own. Sorry they are out of order, I thought it was such a good idea I jumped right in.[/b]
Perfect. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] I hope more will jump right in too.
I think it's great to pull the best parts from all of the letters. Corvallis Mom used my letter as a base, but had her doctor add that she and her husband were "knowledgeable individuals". I thought that was a very excellent addition.

Posted on: Mon, 03/06/2006 - 7:11am
ajas_folks's picture
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Gail, this "Clearing House" approach to these types of info is so very useful! Thanks for getting this going on the Schools Topic section.
Elizabeth

Posted on: Mon, 03/06/2006 - 7:33am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

Yes... My feeling is that the two strongest statements in our letter are the mention that anaphylaxis has an [i]uncertain outcome, no matter what you do at that point[/i] because that emphasizes avoidance, and also that [i]avoidance requires a well-educated adult(s) and cannot be a reasonable expectation of a child. [/i] Voila! We have simultaneously pointed our WHY a 504 plan is needed (inability to care for one's self) and that accommodations will need to include adult supervision!
... and we included information about previous reactions [i]because that was useful in our case[/i].... I also shamelessly plugged our terminal degrees in that "knowledgeable" statement, too! [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img] Heh heh heh.
(How many "doctors" does it take to establish a 504, anyway??) [img]http://uumor.pair.com/nutalle2/peanutallergy/cool.gif[/img]

Posted on: Mon, 03/06/2006 - 8:06am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Quote:Originally posted by Corvallis Mom:
[b]My feeling is that the two strongest statements in our letter are the mention that anaphylaxis has an [i]uncertain outcome, no matter what you do at that point[/i] because that emphasizes avoidance, and also that [i]avoidance requires a well-educated adult(s) and cannot be a reasonable expectation of a child. [/i] Voila! We have simultaneously pointed our WHY a 504 plan is needed (inability to care for one's self) and that accommodations will need to include adult supervision![/b]
Sooo, sooooooo excellent!
Quote:Originally posted by ajas_folks:
[b]Gail, this "Clearing House" approach to these types of info is so very useful! Thanks for getting this going on the Schools Topic section.[/b]
[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] I think it helps too. It was reading Corvallis Mom's letter yesterday thought it would be missed where it was within that thread. It's hard to dig through the threads... plus this way we can 'discuss' what we think is most effective/powerful in the letters posted as well as what c/would improve them.
For example, my letter states, [b][i]"For the purposes of this letter for a Section 504 designation, I attest that Mariah X

Posted on: Mon, 03/06/2006 - 10:14am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Nutternomore's from here: [url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001046.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001046.html[/url]
Quote:Originally posted by Nutternomore:
Here is the text of the doctor's letter. For the most part, we're pretty satisfied with the letter, although he didn't specifically state which major life activities were limited [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img]
-----------------------------------------------
To Whom It May Concern,
D has severe life-threatening peanut and tree nut allergy. I have enclosed an Emergency Treatment Plan to be used in case D is accidentally exposed to a nut product at school and develops anaphylaxis (allergic shock).
D was first exposed to peanut butter in xxx,xxxx. This necessitated an Emergency Room visit for severe hives and respiratory distress. I saw him shortly thereafter and a blood test confirmed that he has life-threatening allergy to peanut as well as other tree nuts. D's degree of allergy is so severe that even minor contact such as transfer of a small amount of peanut butter to his skin could elicit an allergic reaction. D also has significant other allergies and this has caused chronic nasal allergy and asthma. It has been documented in the literature that asthmatics with nut allergy are at higher risk of having a life-threatening episode upon accidental exposure.
It is essential that D not be exposed to peanut or any other nut product at school. However, his parents are anxious for D to participate in school in as normal a fashion as possible. Therefore, we request that all school personnel be aware of D's severe food allergy and that measures be taken to prevent him from being accidentally exposed. It is essential that D have emergency medications consisting of Benadryl, and Epi Pen, an Albuterol asthma inhaler, and a medical device called an Aerochamber to assist in administration of his Albuterol inhaler at school and in the classroom so that immediate use could be instituted if he should have an allergic reaction. It would be wise to keep duplicate medication in the nurse's office. D's Emergency Treatment Kit should accompany him on all school activities out of the classroom. Since the most common source of exposure would be in the school cafeteria, arrangements should be made for immediate access to his Medical Emergency Kit from the cafeteria.
D's parents will be happy to assist school personnel in any way to obtain information from reputable information sources such as the Food Allergy Network to educate school personnel about the necessity of careful restriction of peanut and nut products from D's environment at school and the need for immediate treatment if he should be accidentally exposed.
Sincerely,
XXXX X. XXXXX, M.D.
________________________________________________________
[This message has been edited by Gail W (edited March 06, 2006).]

Posted on: Mon, 03/06/2006 - 11:57am
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Joined: 12/14/2005 - 09:00

Our allergist's letter -
Dr. Mr. Principal:
B. has been a patient at the Allergy and Asthma Center since July of 2005. He has been diagnosed with peanut allergy on the basis of prior clinical reactions confirmed by skin testing for IgE antibody. B. also suffers from episodic bronchial asthma. B. should be considered at high risk for a possible fatal food allergy reaction and therefore should be in an environment wherein potential exposures to peanut allergen are strictly controlled. While an EpiPen Junior should always be available for the treatment of a reaction following an unattended exposure, prevention is the best treatment for B. It is medically necessary for B. to be in an environment where the risk of exposure to peanut allergen is substantially reduced. With proper interventions and preventions, B. will do well in school and can be expected to participate in most activities without risk.
Thank you for participating in B's Care.
Sincerely,
Dr. MD

Posted on: Mon, 03/06/2006 - 10:12pm
notnutty's picture
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Joined: 03/15/2004 - 09:00

We are still in the process of obtaining 504 designation, but I can post the letter the doctor wrote:
Date
Re:
DOB:
To Whom it may concern:
I have cared for since regarding his life-threatening allergies to peanuts (see enclosed lab reports).
Age two, had increased asthma and generalized hives with inhalation of peanuts or contact on his skin requiring an emergency room visit. Since that time he has had more anaphylactic reactions (life threatening) with indirect contact (and perhaps even accidentally minute amounts in salad). In addition to the peanut anaphylaxis, does have asthma which may be triggered by any of his allergy triggers. Because of this he needs to have emergenty use of his medication available at all times, including EpiPen Jr., Benadryl, loratadine, Prelone and albuterol. Given all the above, the life system of breathing is effected in case.
The most important aspect of management of patients with life-threatening alllergies is avoidance. Anyway that peanut residue and its products are eliminated from the school setting and therefore enabling to fully participate in all school activities (while minimize disriptions in the school day and his program for teachers and other students) will be greatly appreciated. It's very important that we also eliminate student/teacher caused contamination of shared services by minimizing peanut products brought to or used in the classroom be instituted.
Sincerely,

Posted on: Mon, 05/01/2006 - 1:56am
Chris PeanutAllergy Com's picture
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Joined: 04/25/2001 - 09:00

TO WHOM IT MAY CONCERN:
(child

Posted on: Mon, 05/01/2006 - 2:05am
Chris PeanutAllergy Com's picture
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Joined: 04/25/2001 - 09:00

search word "doctor letter"
Note: The letter above was not written by PeanutAllergy.Com, it is an actual letter a member received with the names removed before posting.

Posted on: Thu, 05/11/2006 - 12:06pm
Anonymous's picture
Anonymous (not verified)

I found this discussion useful in developing a dr's letter with my dr. I will not post since it duplicates what is already here, but I did write him a note to explain how 504 pertains to allergy since he was more familiar with it's application for ADHD. Writing this was helpful to me as well in understading why, under the law, it applies so I thought I would include it here:
DS will be entering kindergarten at public school in the fall. The school offers 504 protection for his peanut allergy. 504 of the Rehabilitation Act of 1973 protects the rights of persons with handicaps in programs and activities that receive Federal financial assistance. The ED Section 504 regulation defines an "individual with handicaps" as any person who has a physical or mental impairment which substantially limits one or more major life activities including functions such as caring for one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. Section 504 protects the rights not only of individuals with visible disabilities but also those with disabilities that may not be apparent. Hidden disabilities include such conditions and diseases as specific learning disabilities, diabetes, epilepsy, and allergy. This information was taken from the following website, a brochure from the government explaining the 504: [url="http://www.ed.gov/about/offices/list/ocr/docs/hq5269.html"]http://www.ed.gov/about/offices/list/ocr/docs/hq5269.html[/url]

Posted on: Fri, 08/25/2006 - 9:52am
Gail W's picture
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raising

Posted on: Fri, 08/25/2006 - 10:05am
anonymous's picture
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Wow, this is wonderfully helpful! Thank you everyone for sharing.

Posted on: Wed, 12/27/2006 - 5:49am
Gail W's picture
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Joined: 12/06/2001 - 09:00

raising

Posted on: Mon, 01/01/2007 - 5:10am
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Thanks for putting all these letters together!! I faxed copies of letters from alot of you to our Allergist. He is an awesome doc(works at Children's and National Jewish) but he has never done a 504 for anaphylaxis!!! He said *it was about time* when I called with my request!! Can't wait to see what he writes up, I hope it works!!! I will post his when I get it back, see what you all think, you help in more ways then you know!!! THANK YOU!!!!!!

Posted on: Mon, 03/06/2006 - 2:48am
Gail W's picture
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From here: [url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001875.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001875.html[/url]
______________________________________________________
Dr. xxxx
Director of Instructional Resources
xxx School District
May 9, 2005
To Whom It May Concern:
I have been asked by Mariah X's parents to provide medical information regarding Mariah

Posted on: Mon, 03/06/2006 - 2:52am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Rhonda RS's letter from here: [url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/000431.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/000431.html[/url]
________________________________________________________
(Current Date)
(Mother's Name)
(Father's Name)
Patient: (Child's Name): (Date of Birth)
(Home Street Address)
(Town, State, Zip Code)
Telephone: (telephone number)
E-Mail: (parent's e-mail address)
Dear Dr. (Doctor's Last Name),
(We wrote a personal note thanking him/her for working with us and our child and all the help sh/e has given us thus far.)
We are getting ready to send (the child's first name) to (preschool or public school), and want to have (him/her) in place an accommodation plan that addresses his/her safety needs. To achieve this goal, we need a letter from you stating the circumstances surrounding (Child's Name) allergies. This letter will entitle us to important educational meetings. I am asking for a lot of specific information so that the school can really understand the nature of (Child's Name) allergies and the seriousness of (Child's name) peanut allergy. Could you please discuss the following topics? We greatly appreciate your assistance.
1. Could you please address the letter to (Formal Name of the School District) Administrators, School Nurses and Teachers.
2. (Child's) full name and date of birth.
3. Date of allergy testing.
4. List of allergies confirmed.
5. Other medical conditions: ex. Asthma.
6. Type of reaction your (Child) has to allergy, contact, inhalation, ingestion of the allergen.
*7. *Life Systems that are affected by (the child's) allergic reaction: These life systems include: Cardiovascular, digestive, respiratory and skin. *This topic is extremely important. It is especially important to state that anaphylaxis affects the "life system of breathing is affected."
8. Medical Treatment for allergic reactions.
List medicines that must be present with (Child) at all times.
9. List all medicines that (Child) is currently taking.
10. List medical devices that must be present with (Child) at all times (ex. Nebulizer & Albuterol or inhaler).
11. List other devices or medical aids that (Child) needs (ex. hepafilter, creams, etc.).
12. State that my husband and I are knowledgeable individuals who understand our child's condition and his/her safety needs.
Could you please mail the letter to us directly? We will make copies and keep it on file at our home.
In closing, thank you so much for all your help Dr. (Name of the Doctor). We appreciate your support. The documentation that you provide will help us tremendously in attaining our goal of providing (Name of the Child) with a safe and rich public school experience.
Sincerely,
(Name of both of the Parent)
_________________________________________________________

Posted on: Mon, 03/06/2006 - 3:00am
qdebbie1's picture
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Joined: 02/10/2005 - 09:00

School District:
I have been asked by XX

Posted on: Mon, 03/06/2006 - 3:03am
qdebbie1's picture
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Dear School District
X (DOB) is a patient with X Asthma and Allergy Center. It has been brought to my attention that the district is planning to continue serving peanut products in the cafeteria. I was unaware of cafeteria procedures when I signed off on the plan agreeing to eliminate peanut products only from the main menu.
*****this is when the school sent a proposed plan to my doctor and had him sign it and then said see dr x likes it...nice try******
As stated in my previous letter, X requires a safe learning environment in all classrooms, cafeteria and all shared facilities. Strict avoidance of the allergen is the only way to allow him to fully participate in all school activities. In order to reasonably accommodate this student

Posted on: Mon, 03/06/2006 - 3:04am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Corvallis Mom's letter from here: [url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/002166.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/002166.html[/url]
______________________________________________________
To Whom It May Concern:
I have been asked by XXXXX XXXXX's parents to provide medical information regarding XXXXXX

Posted on: Mon, 03/06/2006 - 3:11am
qdebbie1's picture
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Dear School District:
X X () is a patient with the X Asthma and Allergy Center under my direct care. He has been diagnosed with a life threatening peanut allergy. His test results are the highest level making his allergy extremely severe. X also has a history of anaphylactic reactions. This impairment will produce similar or worse reactions in the future. Any exposure to peanut products by ingestion, touch, or smell can cause a reaction that would quickly endanger his major life activity of breathing, possibly resulting in death.
X requires a safe learning environment in all classrooms, cafeteria, and all shared facilities. Strict avoidance of the allergen is the only way to allow him to fully participate in all school activities.
All teachers and staff involved with his education should be made aware of this condition and properly trained to handle emergency situations.
Please contact the office if you need further information.
Sincerely,
X, MD
X Asthma and Allergy Center
x0x-3xx 23x5

Posted on: Mon, 03/06/2006 - 3:14am
qdebbie1's picture
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what a great idea.
you may notice I took some wording from other letters to create my own.
Sorry they are out of order, I thought it was such a good idea I jumped right in.
The last post is the first letter sent to the school. Then the next letter and the pediatrician letter. I also had a letter from his original allergist in ohio but it was more of a form letter version and not as helpful. And a letter from his Nurse practioner but the district said her opinion was invalid. That definately worked in my favor because she didnt like that comment, she lives in the district and was happy to have the pediatrician write anything help.
In total I had 2 letterst from his current allergist
1 from the allergist who did the testing
1 from a np( not on file)
1 from pediatrician.
My consent form only gave permission to talk with the allergist and they never called that I know of, only that tricky tactic at the beginning.
anyone is free to use all/any part of my letters.

Posted on: Mon, 03/06/2006 - 7:05am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Quote:Originally posted by qdebbie1:
[b]what a great idea.
you may notice I took some wording from other letters to create my own. Sorry they are out of order, I thought it was such a good idea I jumped right in.[/b]
Perfect. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] I hope more will jump right in too.
I think it's great to pull the best parts from all of the letters. Corvallis Mom used my letter as a base, but had her doctor add that she and her husband were "knowledgeable individuals". I thought that was a very excellent addition.

Posted on: Mon, 03/06/2006 - 7:11am
ajas_folks's picture
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Joined: 04/28/2000 - 09:00

Gail, this "Clearing House" approach to these types of info is so very useful! Thanks for getting this going on the Schools Topic section.
Elizabeth

Posted on: Mon, 03/06/2006 - 7:33am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

Yes... My feeling is that the two strongest statements in our letter are the mention that anaphylaxis has an [i]uncertain outcome, no matter what you do at that point[/i] because that emphasizes avoidance, and also that [i]avoidance requires a well-educated adult(s) and cannot be a reasonable expectation of a child. [/i] Voila! We have simultaneously pointed our WHY a 504 plan is needed (inability to care for one's self) and that accommodations will need to include adult supervision!
... and we included information about previous reactions [i]because that was useful in our case[/i].... I also shamelessly plugged our terminal degrees in that "knowledgeable" statement, too! [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img] Heh heh heh.
(How many "doctors" does it take to establish a 504, anyway??) [img]http://uumor.pair.com/nutalle2/peanutallergy/cool.gif[/img]

Posted on: Mon, 03/06/2006 - 8:06am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Quote:Originally posted by Corvallis Mom:
[b]My feeling is that the two strongest statements in our letter are the mention that anaphylaxis has an [i]uncertain outcome, no matter what you do at that point[/i] because that emphasizes avoidance, and also that [i]avoidance requires a well-educated adult(s) and cannot be a reasonable expectation of a child. [/i] Voila! We have simultaneously pointed our WHY a 504 plan is needed (inability to care for one's self) and that accommodations will need to include adult supervision![/b]
Sooo, sooooooo excellent!
Quote:Originally posted by ajas_folks:
[b]Gail, this "Clearing House" approach to these types of info is so very useful! Thanks for getting this going on the Schools Topic section.[/b]
[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] I think it helps too. It was reading Corvallis Mom's letter yesterday thought it would be missed where it was within that thread. It's hard to dig through the threads... plus this way we can 'discuss' what we think is most effective/powerful in the letters posted as well as what c/would improve them.
For example, my letter states, [b][i]"For the purposes of this letter for a Section 504 designation, I attest that Mariah X

Posted on: Mon, 03/06/2006 - 10:14am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Nutternomore's from here: [url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001046.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001046.html[/url]
Quote:Originally posted by Nutternomore:
Here is the text of the doctor's letter. For the most part, we're pretty satisfied with the letter, although he didn't specifically state which major life activities were limited [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img]
-----------------------------------------------
To Whom It May Concern,
D has severe life-threatening peanut and tree nut allergy. I have enclosed an Emergency Treatment Plan to be used in case D is accidentally exposed to a nut product at school and develops anaphylaxis (allergic shock).
D was first exposed to peanut butter in xxx,xxxx. This necessitated an Emergency Room visit for severe hives and respiratory distress. I saw him shortly thereafter and a blood test confirmed that he has life-threatening allergy to peanut as well as other tree nuts. D's degree of allergy is so severe that even minor contact such as transfer of a small amount of peanut butter to his skin could elicit an allergic reaction. D also has significant other allergies and this has caused chronic nasal allergy and asthma. It has been documented in the literature that asthmatics with nut allergy are at higher risk of having a life-threatening episode upon accidental exposure.
It is essential that D not be exposed to peanut or any other nut product at school. However, his parents are anxious for D to participate in school in as normal a fashion as possible. Therefore, we request that all school personnel be aware of D's severe food allergy and that measures be taken to prevent him from being accidentally exposed. It is essential that D have emergency medications consisting of Benadryl, and Epi Pen, an Albuterol asthma inhaler, and a medical device called an Aerochamber to assist in administration of his Albuterol inhaler at school and in the classroom so that immediate use could be instituted if he should have an allergic reaction. It would be wise to keep duplicate medication in the nurse's office. D's Emergency Treatment Kit should accompany him on all school activities out of the classroom. Since the most common source of exposure would be in the school cafeteria, arrangements should be made for immediate access to his Medical Emergency Kit from the cafeteria.
D's parents will be happy to assist school personnel in any way to obtain information from reputable information sources such as the Food Allergy Network to educate school personnel about the necessity of careful restriction of peanut and nut products from D's environment at school and the need for immediate treatment if he should be accidentally exposed.
Sincerely,
XXXX X. XXXXX, M.D.
________________________________________________________
[This message has been edited by Gail W (edited March 06, 2006).]

Posted on: Mon, 03/06/2006 - 11:57am
bandbmom's picture
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Joined: 12/14/2005 - 09:00

Our allergist's letter -
Dr. Mr. Principal:
B. has been a patient at the Allergy and Asthma Center since July of 2005. He has been diagnosed with peanut allergy on the basis of prior clinical reactions confirmed by skin testing for IgE antibody. B. also suffers from episodic bronchial asthma. B. should be considered at high risk for a possible fatal food allergy reaction and therefore should be in an environment wherein potential exposures to peanut allergen are strictly controlled. While an EpiPen Junior should always be available for the treatment of a reaction following an unattended exposure, prevention is the best treatment for B. It is medically necessary for B. to be in an environment where the risk of exposure to peanut allergen is substantially reduced. With proper interventions and preventions, B. will do well in school and can be expected to participate in most activities without risk.
Thank you for participating in B's Care.
Sincerely,
Dr. MD

Posted on: Mon, 03/06/2006 - 10:12pm
notnutty's picture
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Joined: 03/15/2004 - 09:00

We are still in the process of obtaining 504 designation, but I can post the letter the doctor wrote:
Date
Re:
DOB:
To Whom it may concern:
I have cared for since regarding his life-threatening allergies to peanuts (see enclosed lab reports).
Age two, had increased asthma and generalized hives with inhalation of peanuts or contact on his skin requiring an emergency room visit. Since that time he has had more anaphylactic reactions (life threatening) with indirect contact (and perhaps even accidentally minute amounts in salad). In addition to the peanut anaphylaxis, does have asthma which may be triggered by any of his allergy triggers. Because of this he needs to have emergenty use of his medication available at all times, including EpiPen Jr., Benadryl, loratadine, Prelone and albuterol. Given all the above, the life system of breathing is effected in case.
The most important aspect of management of patients with life-threatening alllergies is avoidance. Anyway that peanut residue and its products are eliminated from the school setting and therefore enabling to fully participate in all school activities (while minimize disriptions in the school day and his program for teachers and other students) will be greatly appreciated. It's very important that we also eliminate student/teacher caused contamination of shared services by minimizing peanut products brought to or used in the classroom be instituted.
Sincerely,

Posted on: Mon, 05/01/2006 - 1:56am
Chris PeanutAllergy Com's picture
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Joined: 04/25/2001 - 09:00

TO WHOM IT MAY CONCERN:
(child

Posted on: Mon, 05/01/2006 - 2:05am
Chris PeanutAllergy Com's picture
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Joined: 04/25/2001 - 09:00

search word "doctor letter"
Note: The letter above was not written by PeanutAllergy.Com, it is an actual letter a member received with the names removed before posting.

Posted on: Thu, 05/11/2006 - 12:06pm
Anonymous's picture
Anonymous (not verified)

I found this discussion useful in developing a dr's letter with my dr. I will not post since it duplicates what is already here, but I did write him a note to explain how 504 pertains to allergy since he was more familiar with it's application for ADHD. Writing this was helpful to me as well in understading why, under the law, it applies so I thought I would include it here:
DS will be entering kindergarten at public school in the fall. The school offers 504 protection for his peanut allergy. 504 of the Rehabilitation Act of 1973 protects the rights of persons with handicaps in programs and activities that receive Federal financial assistance. The ED Section 504 regulation defines an "individual with handicaps" as any person who has a physical or mental impairment which substantially limits one or more major life activities including functions such as caring for one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. Section 504 protects the rights not only of individuals with visible disabilities but also those with disabilities that may not be apparent. Hidden disabilities include such conditions and diseases as specific learning disabilities, diabetes, epilepsy, and allergy. This information was taken from the following website, a brochure from the government explaining the 504: [url="http://www.ed.gov/about/offices/list/ocr/docs/hq5269.html"]http://www.ed.gov/about/offices/list/ocr/docs/hq5269.html[/url]

Posted on: Fri, 08/25/2006 - 9:52am
Gail W's picture
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Joined: 12/06/2001 - 09:00

raising

Posted on: Fri, 08/25/2006 - 10:05am
anonymous's picture
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Joined: 05/28/2009 - 16:42

Wow, this is wonderfully helpful! Thank you everyone for sharing.

Posted on: Wed, 12/27/2006 - 5:49am
Gail W's picture
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Joined: 12/06/2001 - 09:00

raising

Posted on: Mon, 01/01/2007 - 5:10am
chanda4's picture
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Joined: 12/14/2006 - 09:00

Thanks for putting all these letters together!! I faxed copies of letters from alot of you to our Allergist. He is an awesome doc(works at Children's and National Jewish) but he has never done a 504 for anaphylaxis!!! He said *it was about time* when I called with my request!! Can't wait to see what he writes up, I hope it works!!! I will post his when I get it back, see what you all think, you help in more ways then you know!!! THANK YOU!!!!!!

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