Skip to main content
Sign In

Clinical Resources

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