PARENTS REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNEL
required for all medications
each form can hold up to two medications
must be signed by parent/guardian
child's physician can also sign form which would serve as physician's orders
DIABETES MEDICAL MANAGEMENT PLAN
required (can be physician's own form)
completed and signed by both parent and child's physician
updated each school year or as needed
AUTHORIZATION FOR UNLICENSED DIABETES CARE ASSISTANT (UDCA) - click link to download form
Trained by the school nurse on equipment and medications for diabetes
A UDCA will assist student (emergencies or field trips)
Form required to be filled out ( even if answer is no)
RECOMMENDED DIABETES SUPPLIES FOR SCHOOL
Supplies (glucometer, lancet, ect) have to be supplied by parents
Have refrigerator to keep insulin at school (will stay locked up)
Have cabinet for student to keep snacks for hypoglycemic lows ( parents provide snacks)