Disease Specific ECP | IHP | 504 |Diabetes Addendum | Flow Sheets
Sample Resources Below should be reviewed and approved by the School Medical Director and/or BOE prior to use.
Allergy|Anaphylaxis Care Plans
Asthma Care Plans and Action Plans (AAP)
Asthma Action Plan-NYSDOH (5/2017)
Sample Provider and Parent Guardian Permission for the use of School Provided Spacer/Valved Holding Chamber
Provides schools the opportunity to provide a back-up spacer in the event that the student's is not available. (7/7/20)
Diabetes Medical Management Plans (DMMPs)|Addendum to Allow HCP Provide Criteria for Parents Input on Insulin Dose
Effective Diabetes tools for a successful management of diabetic management. Here you will find a sample Diabetes Medical Management Plan, a sample template for an Individualized Health Care Plan, and sample Emergency Care Plans for Hypoglycemia and Hyperglycemia.
Additional FAQs, as to who can carry out a Diabetic Emergency plan within a school system, how long do they last, etc, please visit, The National Institute of Diabetes and Digestive and Kidney Diseases.
DMMP Addendum: Role of Parents/Guardians in Adjustment of Insulin Dose-Allows the HCP to provide criteria by which the parent may be consulted in adjusting insulin doses administered by a nurse during school hours and at school-sponsored events, to the extent reasonably practicable. 5/2017 Note: HCP orders only allow the parent to provide proposed adjustments or dosages and require the health care professional to make the ultimate decision after exercising his/her professional judgment.
Diabetes Hypoglycemia|Hyperglycemia Plans
Glucagon Training Documentation Form for School Personnel- Documents understanding and skills attainment for staff voluntarily administering glucagon for students with patient-specific orders. This form is also available with the PPT training program on the NYSCSH Glucagon page.
Diabetes Sample 504 Plans
Generic Sample Care Plans and Other Emergency Documentation for Students and Staff
Seizure Sample Care Plans | 504 Plans | Interview Questionnaire for Seizure History