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TN Sumner County Schools Seizure IHP/Safety Plan-Prescription Medication Orders 2017-2025 free printable template

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SUMNER COUNTY SCHOOLS SEIZURE IHP/SAFETY NONPRESCRIPTION MEDICATION ORDERS This portion is to be completed by a PARENT/Guardianship Information Name of Child: Child's Age Date of Birth GradeHomeroom
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How to fill out TN Sumner County Schools Seizure IHP/Safety Plan-Prescription

01
Obtain the TN Sumner County Schools Seizure IHP/Safety Plan-Prescription form from the school or district website.
02
Read the instructions carefully to understand the requirements.
03
Fill in the student’s personal information, including name, date of birth, and grade.
04
Provide detailed medical history related to seizures, including type, duration, and frequency.
05
List the medications the student is currently taking for managing seizures.
06
Describe the emergency procedures to follow in case of a seizure.
07
Include contact information for the student’s healthcare provider.
08
Ensure to gather signatures from the student’s parent/guardian and healthcare provider.
09
Submit the completed form to the school’s health office or designated personnel.

Who needs TN Sumner County Schools Seizure IHP/Safety Plan-Prescription?

01
Students diagnosed with seizure disorders who attend TN Sumner County Schools.
02
Parents or guardians of students with seizure conditions to ensure proper management at school.
03
School staff who need to be informed about the procedures to follow in case of a seizure emergency.
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The TN Sumner County Schools Seizure IHP/Safety Plan-Prescription is a document that outlines the individualized health plan and safety measures for students with seizure disorders in the school environment.
It is typically required to be filed by the parents or guardians of students diagnosed with seizure disorders, along with healthcare providers involved in the student's care.
To fill out the TN Sumner County Schools Seizure IHP/Safety Plan-Prescription, provide accurate medical information about the student's seizure disorder, emergency contacts, specific care instructions, and any necessary medication details.
The purpose of the plan is to ensure the safety and well-being of students with seizures, providing clear guidelines for staff on how to respond in case of a seizure and how to manage the student's health needs at school.
The information required includes the student's medical history, type and frequency of seizures, triggers, emergency intervention steps, medications, and contact information for healthcare providers and emergency contacts.
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