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Carnegie Museums of Pittsburgh Epinephrine Auto Injector Policy and Consent Form Carnegie Museums of Pittsburgh staff and volunteers are not professional medical personnel. We do not provide Epinephrine Auto Injectors. They must be prescribed by a physician for a specific child and brought to camp at one of the Carnegie Museums of Pittsburgh, by a … Continued

Carnegie Museums of Pittsburgh Epinephrine Auto Injector Policy and Consent Form

  • Carnegie Museums of Pittsburgh staff and volunteers are not professional medical personnel.
  • We do not provide Epinephrine Auto Injectors. They must be prescribed by a physician for a specific child and brought to camp at one of the Carnegie Museums of Pittsburgh, by a parent, each time the child is in attendance. The camper will be expected to carry their Epinephrine Auto Injector with them throughout the day, campers may bring a small backpack for this purpose. CMP staff are not permitted to carry the Epinephrine Auto Injector for the camper.
  • If a child requires the possible use of an Epinephrine Auto Injector it should be indicated on the summer camp permission form and signed by the parent/legal guardian.
  • Epinephrine Auto Injector must be properly and clearly labeled with:
    1. the child’s first and last name;
    2. the dosage of Epinephrine; and
    3. the expiration date (We will not accept expired Epinephrine Auto Injectors).
  • Carnegie Museums of Pittsburgh staff and volunteers will only administer an Epinephrine Auto Injector in the event of an emergency where the child is unable to self administer. In such event, Carnegie Museums of Pittsburgh staff and volunteers will administer the Epinephrine Auto Injector in accordance with this Policy provided that the child’s parent/guardian previously provided permission by signing below.
  • If an Epinephrine Auto Injector is administered, 911 and the parent/guardian of the camper will be notified immediately.
  • I give permission to Carnegie Museums of Pittsburgh staff and volunteers to administer my child,
  • Name * Required
  • with their prescribed Epinephrine Auto Injector in case of an emergency.
  • Print Name * Required
  • This field is for validation purposes and should be left unchanged.