ANAPHYLACTIC FOOD ALLERGIES 

The parent or guardian is responsible for notifying school personnel of the presence of a severe anaphylactic food allergy. Upon enrollment, a parent or guardian must indicate if their child has a severe food allergy (see Request for Food Allergy Information Form). 

 

Parents are required to complete and provide the following at the beginning of each school year:

 

• The Food Allergy Action Plan, completed by the child’s physician each school year

 

• If the parent is requesting meal substitutions or modifications, the Special Dietary Accommodations Request Form   from the Food and Nutrition Services (FNS) is completed by the child’s physician and parent.

  Special Dietary Accomodations Request Form (español)

 

• The Authorization for Self-Carry and Self-Administration of Anaphylaxis Medication (EpiPen) must be indicated by physician on Food Allergy Action Plan, if applicable.

 

ASTHMA

 

Effective asthma management in school can help improve a child’s learning environment, reduce absences, reduce classroom disruptions and help children feel safe at school. School staff need to know which children have asthma and understand their individual needs regarding their asthma.

 

Parents are required to provide a Asthma Action Plan, completed and signed by the child's physician at the beginning of each school year.

 

 

Diabetes 

 

House Bill 984 requires that:

• An individualized health care plan be developed for each student with diabetes who will seek care for diabetes while at school or while participating in a school activity.  The plan must be submitted:
  
  • Before or at the beginning of each school year, upon enrollment, or as soon as practicable following diagnosis.
  • Developed and signed by the student’s parent/guardian and the physician responsible for the student’s diabetes. and must include:
    • The health care services the student may receive at school.
    • Evaluate the student’s level of understanding and ability to manage their diabetes.

A particular form is not required.  However, a sample has been provided for your convenience.

Sample Diabetes Care Plan

Student Contract for Self Management of Diabetes

The parent/guardian must also sign an agreement that authorizes an unlicensed diabetes care assistants to assist the student in the absence of a school nurse.  The school nurse will provide a copy for you to sign.

Seizures

 

Dickinson ISD follows the Epilepsy Foundation standards and recommendations to provide care for students with seizures.  Parent/Guardians are responsible for notifying school personnel if their child has a history of seizures. 

 

Parents are required to provide a Seizure Action Plan, completed and signed by the child's physician at the beginning of each school year.

Gastrostomy Tube Feeding Authorization Orders

 

For students who require gastrostomy tube feedings during the school hours, parents are required to provide Physician Orders for Gastrostomy Tube Feeding completed and signed by their physician at the beginning of each school year. 

 

 Special Procedures authorization orders

For students who require special procedures during the school day, such as catheterization, suctioning, diapering, trach care, oxygen or any other special procedures, parents are required to provide a Special Authorization Orders completed and signed by the child's physician at the beginning of each school year.