National templates and state versions of the care plans a student's clinician signs for the school nurse, from the DMMP to anaphylaxis and seizure plans.
School care plans are the clinician's orders for school staff: insulin dosing, epinephrine, inhalers and rescue seizure medication. Most offices use national templates, led by the American Diabetes Association's Diabetes Medical Management Plan (DMMP), the AAP Allergy and Anaphylaxis Emergency Plan, the FARE Food Allergy & Anaphylaxis Emergency Care Plan, the American Lung Association's asthma plan for home and school, and the Epilepsy Foundation's seizure action plans. This page lists 19 forms, including state versions from Colorado, Minnesota and New York.
The parent usually carries the plan between the office and the school nurse. On the DMMP, the parent sends page 1 to the provider, who completes sections 3 to 10 and signs before school starts, and the plan is renewed each year. Colorado's allergy plan is effective only for the school year it is approved. Asthma plans from the ALA, Colorado and Minnesota record whether the student may self-carry an inhaler. 11 forms have a Spanish version. Vero Documents fills PDF forms from the visit note and the chart.
NIH Publication No. 20-HL-5251Green/yellow/red-zone written asthma plan listing daily controller and quick-relief medicines and when to seek emergency care, aligned with the 2020 Focused Updates to the Asthma Management Guidelines.
Plan de manejo médico de la diabetes
School diabetes orders: supervision level, glucose monitoring/CGM, insulin delivery and dosing, low/high glucose management, glucagon, disaster and field-trip plans.
Plan de emergencia para alergias y anafilaxia
Pediatric emergency plan for children with allergies at risk of anaphylaxis: weight-based epinephrine dose and step-by-step treatment for school and child care.
Emergency care plan for a person with food allergy: allergens, symptoms, epinephrine and antihistamine orders, and emergency contacts.
Mi plan de acción de asma para el hogar y la escuela
School-age asthma action plan with parent consent for school administration of medicines and a self-carry/self-administer inhaler attestation.
Individual seizure action plan describing seizure types, first aid, rescue therapy and when to call 911, for caregivers, camps and workplaces.
School version of the seizure action plan: seizure description, school first aid, rescue medication orders and emergency response.
Emergency plan for a patient at risk of anaphylaxis: allergens, symptoms and epinephrine/other medication orders.
Mi Plan de acción de asma
Adult/general green-yellow-red zone asthma action plan listing controller, quick-relief (incl. SMART) medicines and danger signs.
Student-specific seizure plan: seizure types, first aid, rescue medication orders and when to call 911 at school.
School asthma action plan (green/yellow/red zones) signed by the asthma provider and parent.
Asthma action plan for young children in child care, with parent consent for medicine administration by child care staff.
Portable summary of a medically complex child's diagnoses, baseline findings, medications, allergies and emergency management for EMS and emergency departments.
Diabetes provider medication orders for school (insulin by injection/oral agents, or insulin pump) that accompany the Colorado diabetes Individualized Health Plan.
Statewide standard allergy/anaphylaxis emergency plan and epinephrine medication order for schools, effective for one school year (C.R.S. 22-1-119.5).
Statewide school/child care asthma care plan that doubles as the provider's medication order for quick-relief inhaler use and self-carry.
Individual medical seizure action plan used by Colorado schools under HB21-1133 (K-12 seizure training and individual action plans) and 1 CCR 301-112.
Plan De Accion Para Asma - para el niño
Pediatric green/yellow/red asthma action plan that also authorizes school/daycare administration of the listed medicines and records whether the child may self-carry a quick-relief inhaler.
Publication 4850NYSDOH asthma action plan (green/yellow/red zones) for patients and families, used with the NYS Guide for Asthma Management in Schools.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.
On the ADA Safe at School DMMP, red sections belong to the parent and black sections 3 to 10 to the student's diabetes provider (physician, PA or APRN). The provider sets the supervision level, glucose monitoring and CGM use, insulin delivery and dosing, low and high glucose management, glucagon, and disaster and field-trip plans, then signs. The fillable PDF comes in English and Spanish and is renewed each school year.
Both are fillable two-page plans signed by the physician or other health care provider, and both come in Spanish. The AAP Allergy and Anaphylaxis Emergency Plan is pediatric, with a weight-based epinephrine dose and step-by-step treatment for school and child care. The FARE plan lists allergens, symptoms, epinephrine and antihistamine orders and emergency contacts, and its 2025 revision adds intranasal epinephrine dose options.
The American Lung Association's My Asthma Action Plan for Home and School includes parent consent for school medicine administration and a self-carry attestation, with lines for the parent, provider and school nurse. Colorado's Asthma Care Plan doubles as the provider's medication order with self-carry authorization, and Minnesota's child plan records the self-carry choice. The NHLBI Asthma Action Plan has no signature line.
The Epilepsy Foundation's school Seizure Action Plan is widely referenced by state Seizure Safe Schools laws. It covers the seizure description, school first aid, rescue medication orders and emergency response, and the treating provider signs it. The Child Neurology Foundation hosts a 2021 revision with physician and parent signatures. Colorado schools use the Children's Hospital Colorado plan under HB21-1133.