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Health / Diabetes management / Insulin pump / Diabetes mellitus / Hypoglycemia / Insulin / Hyperglycemia / Blood sugar / Diabetic coma / Diabetes / Medicine / Endocrine system


PARENTAL REQUEST For Individual Diabetes Care Plan ____________________(school) Student:
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Document Date: 2013-08-01 09:29:38

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File Size: 42,25 KB

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City

Student / /

Company

Return / /

IndustryTerm

Change infusion site / infusion site / child receiving medical services / blood sugar testing equipment / Diabetes Care / food/insulin instructions___________________________________________________________________________ / Treatment for hypoglycemia / food / /

MedicalCondition

choking / tiredness headache / student’s individualized diabetes / headache / student’s individual diabetes / hyperglycemia / convulsion / nausea / serious / chronic disease / school diabetes / diabetes / diabetic coma / seizure / frequent urination excessive thirst nausea vomiting dehydration / vomiting / student’s diabetes / shakiness trembling sleepiness pale appearance poor coordination dizziness / Check diabetes / Diabetes Parent/Guardian / trained school diabetes / dizziness / individual diabetes / emergency diabetes / appropriate diabetes / used diabetes / hypoglycemia / dehydration / Appropriate infection / /

MedicalTreatment

INSULIN INJECTIONS / insulin pump operation / self care / insulin pump / /

Organization

Student School / Date School / parent/guardian Date School / Telephone Number Date School / Insulin administration / /

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Position

Nurse / Teacher / teacher / Guardian Date Health Care Provider Information Current Physician / school nurse /administrator / Date Teacher / teacher/school administrator / school administrator / bus driver / Administrator / Nurse / Nurse /Administrator / Physician / school nurse / /

Product

INSULIN INJECTIONS / glucagon / /

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