Food Allergy Therapeutic Worksheets & Clinical Practice Forms
Visit the Behavioral Health Resource section for links to additional resources.
SECTION 1 - FOOD ALLERGY THERAPEUTIC WORKSHEETS:
These food allergy-specific therapeutic worksheets offer guidance and opportunities to process feelings such as anxiety and worry, explore thoughts and mindsets, and work through problem solving related to navigating the social-emotional aspects of life with allergies. These worksheets are resources for allergic individuals/families,
as well as providers supporting those managing allergies.
SECTION 2 - FOOD ALLERGY CLINICAL PRACTICE FORMS FOR PROVIDERS
Psychosocial Information Intake Forms: With therapy and allergy practice versions available, these intake forms simplify and streamline the allergy psychosocial information gathering process. Questions on these forms gather detailed patient narratives related to the psychosocial, quality of life, and anxiety impacts of living with food allergies. [Separate intake forms available for children, adolescents, adults and parents/caregivers].
IMPORTANT DISCLAIMERS - PLEASE READ:
1). Corporations and those using these documents for training purposes need to
contact Tamara Hubbard, LCPC directly, as there is an additional licensing fee that applies for
using these materials in these instances. 2) Therapeutic worksheets are for educational purposes only
and should not take the place of mental healthcare guidance from a qualified healthcare provider. 3). Worksheets may not be edited and copyright/attribution statement must remain
Copyright © 2018-2022 Tamara Hubbard, LCPC, LLC (Food Allergy Counselor). All Rights Reserved.
Section 1 - Food Allergy Therapeutic Worksheets
Worksheets For Personal Use:
This version of the worksheets is for individuals, parents and families planning to use these for their own
personal use without permission to copy and distribute with others (see disclaimers at top of page). Click on each worksheet image for more information and to see additional pages. Healthcare & Therapy Providers: Please see the "Clinical Use" section below, which offers versions that can be copied and distributed to patients.
Worksheets For Clinical Use:
This version of the worksheets are for allergists, healthcare providers and therapists/psychologists to
share with patients. The price is higher to reflect the permission to distribute with patients (see disclaimers at top of page). Click on each worksheet image for more information and to see additional pages. For personal use versions of these worksheets, see the section above.
Section 2 - Food Allergy Clinical Practice Forms
Food Allergy Psychosocial Intake Forms - Therapy Practice Versions:
Parent/Caregiver Food Allergy Psychosocial Information Form [Therapy Practice Version]
Gather important information related to the psychosocial, quality of life, and anxiety impacts parents/caregivers experience and observe their allergic child or teen experiencing.
Suggested Use: Have patients complete this as part of the intake process.
Benefits of Use: Provides narrative insights into how patients navigate allergy life.
*Personalize this form by adding your practice logo and contact information*
Child Food Allergy Psychosocial Information Form [Therapy Practice Version]
Gather important information related to the psychosocial, quality of life, and anxiety impacts your allergic children patients are experiencing.
Suggested Use: Have patients complete this as part of the intake process
Benefits of Use: Provides detailed narrative insights into how patients navigate allergy life
*Personalize this form for your practice by adding your practice logo and contact information*
Adolescent Food Allergy Psychosocial Information Form [Therapy Practice Version]
Gather important information related to the psychosocial, quality of life, and anxiety impacts your allergic teen patients are experiencing.
Suggested Use: Have patients complete this as part of the intake process
Benefits of Use: Provides detailed narrative insights into how patients navigate allergy life
*Personalize this form for your practice by adding your practice logo and contact information*
Adult Food Allergy Psychosocial Information Form [Therapy Practice Version]
Gather important information related to the psychosocial, quality of life, and anxiety impacts your allergic adult patients are experiencing.
Suggested Use: Have patients complete this as part of the intake process
Benefits of Use: Provides detailed narrative insights into how patients navigate allergy life
*Personalize this form for your practice by adding your practice logo and contact information*
Package Set: All 4 FA Psychosocial Information Forms [Therapy Practice Version]
Need all 4 versions of the food allergy psychosocial information forms? Choose this option to receive a 10% discount by purchasing the full set!
In this package, you'll get the following forms, all which can be personalized for your practice:
-Parent/Caregiver FA Psychosocial Information Form
-Child FA Psychosocial Information Form
-Adolescent FA Psychosocial Information Form
-Adult FA Psychosocial Information Form
Food Allergy Psychosocial Intake Forms - Allergy Practice Versions:
Child Food Allergy Psychosocial Information Form [Allergy Practice Version]
Gather important information related to the psychosocial, quality of life, and anxiety impacts your allergic children patients are experiencing.
Suggested Use: Have patients complete this as part of the intake process
Benefits of Use: Provides detailed narrative insights into how patients navigate allergy life
*Personalize this form for your practice by adding your practice logo and contact information*
Parent/Caregiver Food Allergy Psychosocial Information Form [Allergy Practice Version]
Gather important information related to the psychosocial, quality of life, and anxiety impacts parents/caregivers experience and observe their allergic child or teen experiencing.
Suggested Use: Have patients complete this as part of the intake process.
Benefits of Use: Provides narrative insights into how patients navigate allergy life.
*Personalize this form by adding your practice logo and contact information*
Adolescent Food Allergy Psychosocial Information Form [Allergy Practice Version]
Gather important information related to the psychosocial, quality of life, and anxiety impacts your allergic teen patients are experiencing.
Suggested Use: Have patients complete this as part of the intake process
Benefits of Use: Provides detailed narrative insights into how patients navigate allergy life
*Personalize this form for your practice by adding your practice logo and contact information*
Adult Food Allergy Psychosocial Information Form [Allergy Practice Version]
Gather important information related to the psychosocial, quality of life, and anxiety impacts your allergic adult patients are experiencing.
Suggested Use: Have patients complete this as part of the intake process
Benefits of Use: Provides detailed narrative insights into how patients navigate allergy life
*Personalize this form for your practice by adding your practice logo and contact information*
Package Set: All 4 FA Psychosocial Information Forms [Allergy Practice Version]
Need all 4 versions of the food allergy psychosocial information forms? Choose this option to receive a 10% discount by purchasing the full set!
In this package, you'll get the following forms, all which can be personalized for your practice:
-Parent/Caregiver FA Psychosocial Information Form
-Child FA Psychosocial Information Form
-Adolescent FA Psychosocial Information Form
-Adult FA Psychosocial Information Form
Feedback on Therapeutic Worksheets
"I am the nurse (in our practice) who educates and chats to all the anxious teens, and I give them your work sheets to do at home., especially the Thinking Traps & Mindset (worksheets). I've seen these worksheets help patients make incredible improvements!" -Allergy Nurse
"I used some of your wonderful tools today while helping a patient come to terms with anxieties related to her food allergies and several anaphylactic reactions. My patient found them so helpful, especially the Thinking Traps worksheet. The whole medical team read all your worksheets, and we all agreed they are applicable to everyone - we all took something from them! So, thank you for the time you take to create these pieces - know that they are helping so many!
-UK-based Allergy/Immunology Allied Healthcare Professional
I want to thank you again for the absolute treasure trove you have compiled at your website, Food Allergy Counselor. In my work with participants in clinical trials at the Sean N. Parker Center for Allergy & Asthma Research at Stanford University, I find these materials invaluable for parents and teens. Recently in private practice I had less than 30 minutes to get ready for a new intake all about FA Anxiety and OIT dosing, and I was able to print out a pile of resources for this family before their appointment time thanks to your website.
I don’t know that I could find all these resources online if you hadn’t compiled them at Food Allergy Counselor, but one thing I do know is that I am a better FA therapist because of you & your work! Thank you again!
-Marté J. Matthews, MA, MFT 45249
Clinical Director, Child & Family Counseling Group, San Jose CA
Consulting Family Therapist at Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford CA