Individual Health Care Plans and Emergency Information Forms
An Individual Health Care Plan (IHCP or IHP) can be developed for your child’s home or school. The IHCP:
- Gives the school necessary medical information about your child
- Identifies your child’s health needs, such as giving medication during the school day
- Creates solutions to potential health problems that can occur in a school environment
- Develops plans for emergency medical situations
- Provides a safe environment that helps your child learn
- Makes goals for your child’s health care, such as having your child work towards remembering to take medication
To create an IHP for your child, work with your child’s physician. Most physicians have IHP forms for specific health conditions, and most forms require the physician’s signature prior to submitting it to your child’s school. Below are both general, blank sample health plans, as well as plans that are specific to a child’s condition, that were compiled from a variety of sources.
General Sample Individual Health Plan The general sample IHP is a great tool to develop a specific health plan for your child in conjunction with your child’s physicians and school.
- Asthma Individual Health Care Plan
- Diabetes Individual Health Care Plan
- Seizure Individual Health Care Plan, Sample 1
An Emergency Information Form is a form you, as a parent, can use to hand to doctors when you go to the emergency room with your child. Medical emergencies can be complicated for children with special health care needs. By having an Emergency Information Form, you can make it easier for doctors to treat your child during an emergency. The form includes:
- a place to record contact information for your child
- a list of your child's physicians and their contact information
- base-line findings
- procedures to be avoided
- common presenting problems with specific suggested managements for your child
Below are general, blank sample emergency information forms, available as a PDF or interactive Word document.
- Emergency Information Form for Children with Special Needs (pdf version)
- Emergency Information Form for Children with Special Needs (word doc version)
An Emergency Care Plan (ECP) is a plan that gives specific steps for school professionals to take when your child has a medical emergency. An ECP is written for a child who is more likely to have a specific medical emergency and can be part of the IHP or written separately.
- Asthma Emergency Care Plan
- Food Allergy Emergency Care Plan
- Latex Allergy Emergency Care Plan
- Insect Sting Emergency Care Plan
- Hyperglycemia Emergency Care Plan
- Hypoglycemia Emergency Care Plan
- Seizure Disorder Emergency Care Plan
To learn more about health or emergency care plans, contact PACER’s Health Information Center at (952) 838-9000 or (800) 53-PACER, toll free in Minnesota.