HTML Preview Child Health Care Plan page number 1.


CH-15
SEP 08 Page 1 of 2 Pages.
CARE PLAN FOR CHILDREN WITH SPECIAL HEALTH NEEDS
-To be completed by a Health Care Provider-
Today’s Date
Child’s Full Name
Date of Birth
Parent’s/Guardian’s Name
Telephone No.
( )
Primary Health Care Provider
Telephone No.
( )
Specialty Provider
Telephone No.
( )
Specialty Provider
Telephone No.
( )
Diagnosis(es)
Allergies
ROUTINE CARE
Medication To Be
Given at Child Care
Schedule/Dose
(When and How Much?)
Route
(How?)
Reason
Prescribed
Possible
Side Effects
List medications given at home:
NEEDED ACCOMMODATION(S)
Describe any needed accommodation(s) the child needs in daily activities and why:
Diet or Feeding:
Classroom Activities:
Naptime/Sleeping:
Toileting:
Outdoor or Field Trips:
Transportation:
Other:
Additional comments:
DOWNLOAD HERE


People don’t believe what you tell them. They rarely believe what you show them. They often believe what their friends tell them. They always believe what they tell themselves. | Seth Godin