Get Glucagon Certification Form - Health Ny

Filling out the Glucagon Certification Form is an essential task for school personnel who wish to provide emergency assistance to students with diabetes. This guide aims to help you navigate the form effectively and ensure you have all required information readily available.

Follow the steps to complete the Glucagon Certification Form

1. Press the ‘Get Form’ button to obtain the Glucagon Certification Form and open it for editing.
2. Begin by entering your name in the 'Name of Volunteer Personnel' section. Ensure that your name matches your official identification for consistency.
3. Next, input the name of the school where you are employed in the 'School' section. This identifies your affiliation clearly.
4. In the 'Knowledge Sets' section, you will need to document the dates on which you demonstrated competency in various skills related to glucagon administration. This will typically involve understanding symptoms of hypoglycemia, treatment protocols, and the purpose and side effects of glucagon.
5. Move on to the 'Skill Sets – Administering Glucagon' subsection. Here, check off the necessary skills you have mastered, such as proper injection techniques and emergency protocols. Ensure to fill in the date next to each successfully demonstrated skill.
6. After completing the competency and skills checklists, wait for your school nurse or trainer to sign and print their name in the designated fields to validate your training.
7. The school administrator will also need to sign and print their name under their designated section, confirming your role and training.
8. As the volunteer trained personnel, you must sign and enter the date to confirm your understanding of the training and your willingness to provide assistance in emergencies.
9. Once all sections are completed and signed, you can save changes, download the form for your records, or print out a hard copy for submission.

Complete your Glucagon Certification Form online today and ensure you're prepared for emergencies.