3.10.4 Individualized Health Plans, Emergency Care Plans and Medication Forms

Students with chronic health conditions like asthma, diabetes, allergies, and seizure disorders will need health services at school, such as appropriate procedures, medication or emergency response.  Individualized health plans and emergency care plans provide information for school staff on how to manage a health condition or handle an emergency situation which may occur as a result of the student's health condition. 

• Individualized health plans and emergency care plans need to be completed each year by the student’s healthcare provider and parent/guardian/caregiver.
• If the individualized health plan or emergency care plan includes the administration of medication, a medication form must also be completed and signed by the healthcare provider and parent/guardian/caregiver.
• All medications and delivery devices need to be supplied to the school by the parent/guardian/caregiver in a pharmacy-labeled or original container/dispenser.
• Emergency care plan and medication forms are available at www.sfusd.edu and in this chapter of the Handbook. 
• If you have questions, please call the SFUSD Nurse of the Day through the Student, Family and School Resource Link, 415-340-1716 or email sflink@sfusd.edu.

You may find forms for individualized health plan/emergency care plans and medical authorization below:

• Emergency Care Plan forms
• Medication Form (one medication per form)
• Allergy Emergency Care Plan
• Medical Form for Epinephrine Auto Injector
• Asthma Emergency Care Plan
• Asthma Medication Form (one medication per form)
• Diabetes Emergency Care Plan
• Seizure Emergency Care Plan
• Physician Authorization for Administration of Emergency Anti-Seizure Medication (EASM)

See the full Handbook and downloadable, translated PDFs at sfusd.edu/Handbook.