The Child Advocate
Home
What'sNew
Subjects
Contents
Feedback
Search
Diabetes has long been a problem for countless children. The Child Advocate is devoted to children and the parents and professionals that work with them and advocate for them. Here is a example document originally developed by Dr. Mary Simon and shared through Bear Skin Meadow Camp. This document goes a long way toward addressing school issues in the use of diabetes testing in the classroom. The information presented at this site is for general use only and is not intended to provide personal advice or substitute for the advice of a qualified professional. If you have questions about the information presented here, please consult a physician skilled in diabetes management, the resources listed or other professional in your area.
Diabetes in Children (return to main diabetes page)
![]()
PHYSICIAN'S AUTHORIZATION
SUGGESTED PROTOCOL FOR BLOOD
SUGAR TESTING IN THE CLASSROOM
STUDENT
NAME______________________________________________
DOB____________________________________
ADDRESS____________________________________________________
CITY____________STATE____ZIP__________
(Based
on official protocol adopted 5/31/94)
Diabetic
Students: Under the physician and parent's authorization, test kits for diabetes
may be carried by students and tests administered on campus and in classrooms
under the following conditions:
If
the test is administered in the classroom:
1)
The pupil's teacher is given notice when the test is being administered.
2)
Test administered in an area away from other students.
3)
If the student is not acting responsibly, the testing will be confined to the
health office.
4)
All sharp objects and contaminated materials used for testing shall be stored in
a hard closed container carried by the individual student.
Materials are to be disposed of in a biohazard container located either
in the health office or off campus.
5)
Snacks or glucose tablets will be allowed in the classroom at regular intervals
based on individual need and to alleviate a low‑blood sugar episode.
6)
Universal precautions utilized at all times.
The
medical justification for providing the procedure(s) during school hours is
Insulin Dependent Diabetes Mellitus.
Parent/Guardian
Signature_____________________________________________________________
Duration
of Procedure(s) to be in effect: _________________Date
Reviewed: _____________________
_________________________________
Physician
Medical
Center
Anytown,
CA 55555
![]()
Home
What'sNew
Subjects
Contents
Feedback
Search
The Child Advocate Diabetes Testing Page.
Copyright © 2000-2013 The Child Advocate All rights reserved.
Revised: January 01, 2013
.