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Parent/Guardian Phone(s) Correction Dose: unit(s) of per over Date Time Blood Glucose (BG) Carbohydrate Intake (CHO) Signature of staff providing care to CHO ratio: give unit(s) of per grams of CHO eaten (or to be eaten) Dose for BG Initials for CHO Total Hypoglycemia Treatment Hyperglycemia Treatment Signature of staff providing care Adapted with permiss.
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