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Individualized Health Care Plans

If your student has a medical condition that requires care or support at school, the district must have a signed health care plan on file.  Care plans are good for one year from the date signed, and therefore must be updated annually.

CONDITION

NOTES

                  FORMS

ASTHMA

Care plan needed if medication will be be stored at school OR self carried by student


ASTHMA CARE PLAN 
Please print and have signed by physician, parent, and student (if self-carrying)

ALLERGIES/ANAPHYLAXIS

Severe requiring medication

Care plan needed if medication will be be stored at school OR self carried by student

 

ALLERGY CARE PLAN
Please print and have signed by physician, parent, and student (if self-carrying)

 

DIABETES - TYPE 1

We must have a DMMP (diabetes medical management plan) on file for all students with Type 1 Diabetes 

Ask your physician for a DMMP.  This should be signed by physician and parent

SEIZURE DISORDER

We must have a Care Plan for students with known seizure disorders.

 

We can accept your physician’s own Seizure Care Plan form OR print and have physician sign the  LGSUHSD SEIZURE CARE PLAN

MEDICATION (OTHER) NEEDED DURING SCHOOL HOURS

 

We must have physician and parent signed authorization to store and administer medication, including over-the-counter meds. Medication must be in its original container, and prescription medications must have original Rx label

 

MEDICATION AUTHORIZATION FORM
Please print and have signed by the physician and parent.