Medical Forms - Individual Diabetes Health Care Plan

If your child has been diagnosed with a special health concern that may require routine or emergency medication and treatment while in school, Primary Care Provider (PCP) Authorization Forms are required. This form must be updated every school year and signed by both the Parent/Guardian and the Physician to be valid. Forms are kept in the school office and provide individual emergency plans.

Form C:  Individual Diabetes Health Care Plan – To be used if NOT using your child’s Diabetes Management Plan from their Endocrinologist.