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Clinical Resources (Spanish)

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Diabetes Resources for Healthcare Providers, Families, Schools and Educators: Checklists, Forms & Sample Letters

Many of these forms can be found in the 11th edition of Dr. Peter Chase's book, Understanding Diabetes. Click here for the online version of this excellent book for families on the management of diabetes.

All documents are presented in both Adobe Acrobat file format (*.pdf) and Microsoft Word format (*.doc). Adobe Acrobat Reader can be downloaded free from Adobe's web site.

Form Name​

​Word File ​PDF
1. ADA Diabetes Medical Management Plan
​2. ADA Sample Section 504 Plan
​3. Blood Sugar/Carb/Gram Fax Sheet
​4. CGM Slideset
​5. Daily Record Sheet for Insulin Management Download​ Download​
​6. Daily Record Form for Pump Management
​7. Emergency Response Plan
​8. Individualized Healthcare Plan Check List for the School Nurse
​9. Individualized School Healthcare Plan: Diabetes
​10. Insulin Pumps in the School Setting
​11. Interventions for Emergency Situations
​12. Low Blood Sugar Care for Type 1 Diabetes
​13. Medical Order for Medication & Treatment in School
​14. Parent Sick Day
​15. Sample "Safe Administration & Use of Glucagon" Letter
including "How to Give Glucagon, for Severe Low Blood Sugar in Children with Type 1 Diabetes"
​16. School Blood Sugar Record Sheet
​17. School Diabetes Management Checklist for Parents
​18. School Health Plan for Children on an Insulin Pump
​19. School Intake Interview - Diabetes
​20. School Letter
​21. Sick Day Management
​22. Three Day Food Record Form
​23. When Your Child is Ill Flowchart
​24. S​afemail Instructions for Caregivers/UCDenver Employees
​25. Safemail Instructions for Patients