• Below are blank action plans that should be filled out and signed by your childs physician. An action plan is a written document explaining to school staff exactly how to treat your child while at school for certain conditions and what steps the physician would like school staff to take in case of emergency. There must be an action plan on file for all students with these conditions: Asthma, Anaphylaxis, Diabetes, and Seizure.

    There is a sample seizure action plan below if you would like to see what kind of information it should include. 

    If your child has a diagnosis not listed and you would like a blank action plan to take to the childs doctor please let me know. 

    The health history form should be filled out for any student with a medical condition. These can be printed off at home and sent with student to give to the nurse or a copy can be sent be home with your student if a printer is not available at home.