Get Individual Health Carre Plan Form

Completing the Individual Health Care Plan Form online is crucial for ensuring the health and safety of children in care programs. This guide provides step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Indicate who created the plan by checking the appropriate box: parent, doctor or licensed practitioner, program’s health care consultant, older school age child (9+ years of age), or other. If applicable, specify other.
3. Mark who maintains the plan by checking the relevant role: director, assistant director, child’s educator, or other. Again, specify if necessary.
4. Enter the name of the child in the designated field.
5. Fill in the date to indicate when the form is being completed.
6. Indicate if there are any changes to the child’s Health Care Plan. If yes, specify the changes, including the name of the chronic health care condition.
7. Provide a description of the chronic health care condition and outline any symptoms experienced by the child.
8. Detail the medical treatment that is necessary while the child is in the program.
9. List any potential side effects of the treatment and the consequences if the treatment is not administered.
10. Identify the educators who have received training addressing the medical condition.
11. Provide the name of the person who trained the educator, specifying if it is the child’s health care practitioner, parent, or the program’s health care consultant.
12. Fill out the name of the licensed health care practitioner, ensuring to print it clearly.
13. Obtain the signed authorization from the licensed health care practitioner along with the date.
14. Secure parental or guardian consent by having them sign and date the form.
15. For older children (9+ years), ensure written consent is documented allowing them to carry their own inhaler or epinephrine auto-injector.
16. Record the age and date of birth of the child in the respective fields.
17. Indicate whether backup medication has been received by checking yes or no.
18. Include the parent’s signature and the date to finalize the approval.
19. The administrator should sign and date the form to complete the process.
20. Once all fields are filled, save your changes. You may also download, print, or share the form as needed.

Complete your forms online today to ensure the health and safety of your child.