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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.

Puede encontrar estos formularios y más información en el libro, "Un Primer Libro para Entender La Diabetes." Ordene Aqui

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
Registro de los Niveles de Glucosa/Cetones y Dosis de Insulina
Download
Descargar
Download
Descargar
6. Daily Record Form for Pump Management Download
Excel File
Download
7. Emergency Response Plan Download Download
8. Individualized Healthcare Plan Check List for the School Nurse Download Download
9. Individualized School Healthcare Plan: Diabetes
Órdenes del Proveedor de Atención Médica para Estudiantes con Diabetes Usando Inyecciones
Download
Descargar
Download
Descargar
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
Manejo de la Diabetes en la Escuela y Lista de Provisiones para los Padres
Download
Descargar
Download
Descargar
18. School Health Plan for Children on an Insulin Pump
Órdenes del Proveedor de Atención Médica para Estudiantes con Diabetes Usando Bomba de Insulina
Download
Descargar
Download
Descargar
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. Information for Babysitters or Grandparents
Información para la Niñeras o Abuelos
Download
Descargar
Download
Descargar
25. Safemail Instructions for Caregivers/UCD Employees
Download
Download
26Safemail Instructions for Patients Download Download​