2015- 2016 School Packet Information

  1. Must be a current patient

  2. Allow 72 hours for forms to be processed.

  3. No school packets will be issued on a walk in basis.

  4. To receive insulin orders / pump settings orders you must contact our office 2 weeks, prior to the start of school.  At that time you can either provide us with a self-addressed stamped envelope, or a valid email address, or the school's fax number so the educators can send them to the appropriate place.

  5. Please make every effort to keep up with your child's school packet.  If it does become lost you may obtain a duplicate copy at our discretion by doing one of the following:

    • Provide a self-addressed stamped manila envelope
    • Provide a valid email address
    • Schedule a time to come back to our clinic

It is your responsibility to contact our office 2 weeks prior to the start of school in order for this to take place.

Thank you in advance for your cooperation.

School Forms: 

Diabetes Treatment and Intervention Form (PDF)

2015-2016 Diabetes Medical Management Plan