A NOTE FROM THE REAGAN CLINIC REGARDING STUDENTS WITH DIABETIC NEEDS / MEDICATIONS:

Dear Parents of Students with Diabetes,

I know this looks ominous, but we really need this information completed BEFORE your student starts school next year.  
We encourage all of our students to have permission to be self-managers, so they may self-manage on field trips, as well as, before and after school activities.
For daily needs at school, they may either come to the clinic or self-manage. We just need to know how you would like it handled.  Click on the title of each form to access and fill it out.

1. TEACHER INFORMATION FORM - This is the information relayed to your child’s teachers. Please include ALL information you would like for them to know. Please write on the back if needed.
2. TREATMENT PLAN FORM - This needs to be filled out by either the parent or the physician but signed by both.
3. AUTHORIZATION TO SELF-MANAGE FORM - This form only needs to be signed IF your student will be a self-manager which gives your student permission to check or manage their diabetes anywhere on the school campus or at any school function. If your student will not be a self-manager, this form does not need to be signed.
4. SUPPLEMENT FOR STUDENTS WEARING AN INSULIN PUMP FORM - If your student is wearing a pump, this needs to be completed by the parent or the physician (or diabetic coordinator) and signed by both.

Please return this the week BEFORE school starts or the FIRST day of school.

Thank you so much for your time and effort helping us to comply with state and district policies.

Have a WONDERFUL and SAFE summer!!!  

 Gigi Franklin, RN      Pam Gonzalez, LVN       Rose Mata, CA

 gheyla@neisd.net              pgonza24@neisd.net

Please return forms in person, fax to (210) 482-2222 or email to above addresses.