SPECIFIC CONDITION/HEALTH PLANS

· General Health Issues Form: Please print and complete this form if you child has a medical condition which the school needs to assist in monitoring or which impact his or her educational needs.

· Medication Administration Form

· Asthma Plan: “If you have asthma, it is recommended that you have a plan developed between you and your healthcare provider that gives specific instructions for early treatment of asthma symptoms.  An asthma action plan is a written, individualized worksheet that shows you the steps to take to prevent your asthma from getting worse.  It also provides guidance on when to call your healthcare provider or when to go to the emergency room right away.” (Illinois Lung Assoc site)

· Diabetes Action Plan

· Food Allergy Action Plan

ADDITIONAL INFORMATION AND RESOURCES:

Asthma:

http://www.lungusa.org/lung-disease/asthma/

http://www.lungusa.org/lung-disease/asthma/in-schools/

Food Allergies:

Illinois State Board Of Education Food Allergy Guidelines

Paxton Buckley Loda District Policy

Diabetes:

http://www.idph.state.il.us/public/hb/hbdiabet.htm

http://www.idph.state.il.us/diabetes/index.htm

http://www.cdc.gov/diabetes