[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-243502-105":53,"doc-detail-243502-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","student-medical-condition-plan-pro-forma","Student Medical Condition Plan - Pro-Forma","","Student Medical Condition Plan pro-forma for documenting a known student medical condition that may require school intervention or could lead to a medical emergency needing first aid or other care. Completion is required by the child’s Parent/Carer/Guardian and endorsed by the Medical Practitioner as per the specified section. The plan should be reviewed annually or whenever the medical condition changes, and parents must notify the school immediately of updates affecting the form.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/student-medical-condition-plan-pro-forma/243502/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/student-medical-condition-plan-pro-forma/243502.png","ImageObject",442,249,{"name":88,"@type":89},"Mimi","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-12","2026-09-12",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"Who must complete the Student Medical Condition Plan and who endorses it?","Question",{"text":109,"@type":110},"The plan is completed by the child’s Parent/Carer/Guardian and endorsed by the child’s Medical Practitioner as required in Section C.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"When is this plan required, and when is it not needed?",{"text":114,"@type":110},"It is required for students with a known medical condition that needs intervention or could lead to a medical emergency requiring first aid or other care. It is not needed when the student already has a medical action plan specifically related to the diagnosis.",{"name":116,"@type":107,"acceptedAnswer":117},"How should the plan be maintained over time?",{"text":118,"@type":110},"The plan must be reviewed annually or when the student’s medical condition changes, and parents/carers/guardians must inform the school immediately of changes that impact the form’s contents.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},243502,1790586982,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":73},2336477974920,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Student Medical Condition Plan  \nIntroduction  \nThis plan is required for any student with a known medical condition, either short or long term , that:  \n• Requires intervention, e.g. PEG feed, wound dressing , etc.  \nStudent Photo  \n• Could lead to a medical emergency requiring first aid response or other medical care.  \nThis form should be completed by the child’s Parent/Carer/ Guardian and endorsed by the child’s Medical Practitioner as per Section C.  \nThis form does not need to be completed if the student has a medical action plan which specifically relates to their diagnosis, e.g. asthma, anaphylaxis, diabetes, or epilepsy.  \nThese conditions require completion of specific Medical Action Plans which can be found on peak body websites such as the Australasian Society of Clinical Immunology and Allergy (ASCIA) , Asthma Australia , Diabetes Australia , or Epilepsy Tasmania or through the treating Medical Practitioner.  \nThis plan must be reviewed annually or when your child’s medical condition changes.  \nParents/carers/guardians must inform the school immediately if there are any changes to their child’s condition that will impact the contents of this form.  \n\n| Section A – Personal Details (please fill in clearly) |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| Student’s Name |  |  | Date of Birth |  | Gender | M 􀂅 F 􀂅 Other   |\n| School |  |  | Grade |  |  |  |\n| Parent / Carer / Guardian Name |  |  | Address |  |  |  |\n| Telephone Contact | Home |  | Business |  | Mobile |  |\n| Emergency Contact 1 |  |  |  | Telephone |  |  |\n| Emergency Contact 2 |  |  |  | Telephone |  |  |\n| Name of Medical Practitioner |  |  |  | Telephone |  |  |\n\n| EMERGENCY TREATMENT ACTIONS\u003Cbr>If there’s an emergency, what steps do we need to take? |\n| --- |\n| Step 1: |\n| Step 2: |\n| Step 3: |\n| Call ambulance when the student: |\n\n| Section B – Medical Management |  |  |\n| --- | --- | --- |\n| Is assistance required from school staff? | Yes 􀂅 | No 􀂅 |\n| Can your child independently manage their medical condition? | Yes 􀂅 | No 􀂅 |\n| Does your child need to take prescribed medication during school time? * | Yes 􀂅 | No 􀂅 |\n\n* If yes, please also complete and attach an Authorisation for Administration of Student Medication Form.  \n\n| Section C – Parent / Carer / Guardian Authorisation and Medical Practitioner Endorsement |  |  |  |\n| --- | --- | --- | --- |\n| 1. I give permission for my child to:\u003Cbr>a. be treated by school staff in accordance with this plan if required.\u003Cbr>[b. be](b. be) identified as set out in section D below. This may include a photograph of my child and their required treatment information being displayed in the school’s first aid and medical treatment room/s, staff room/s and other locations considered appropriate.\u003Cbr>2. As a parent/carer/guardian I will notify you immediately of any change to this plan and provide an updated version. |  |  |  |\n| Parent / Carer / Guardian Name |  |  |  |\n| Parent / Carer / Guardian Signature |  | Date |  |\n| Medical Practitioner Endorsement- I am aware of, and support, the health care treatment/actions outlined in Section D of this form. |  |  |  |\n| Medical\u003Cbr>Practitioner Name |  | Title |  |\n| Medical Practitioner Signature |  | Date |  |\n\n\n| Section D – Medical Condition Response Plan |  |\n| --- | --- |\n| Student Name |  |\n| Medical Condition |  |\n| Please describe your child’s usual symptoms, triggers and the action that is typically taken to help them: |  |\n\nWhat signs or symptoms will tell us that your child needs Emergency Treatment?  \n\n|  |\n| --- |\n| Please detail any regular actions that need to happen at school to help support your child eg, supervision, giving them medication, perform a task for them. |\n| SAFETY GUIDELINES / CONSIDERATIONS / INTERVENTIONS\u003Cbr>What do we need to be aware of?\u003Cbr>Please list any safety guidelines /considerations / interventions that may be required in the below areas of school |\n| In the classroom: |\n| In the playground: |\n| On excursio","cbCaigkEPaRv0pRj","https://ap.wps.com/l/cbCaigkEPaRv0pRj","pdf",185135,"English","# Introduction\n## Section A – Personal Details\n## Emergency Treatment Actions\n## Section B – Medical Management\n## Section C – Parent/Carer/Guardian Authorization and Medical Practitioner Endorsement\n## Section D – Medical Condition Response Plan\n## Safety Guidelines/Considerations/Interventions","[{\"question\":\"Who must complete the Student Medical Condition Plan and who endorses it?\",\"answer\":\"The plan is completed by the child’s Parent/Carer/Guardian and endorsed by the child’s Medical Practitioner as required in Section C.\"},{\"question\":\"When is this plan required, and when is it not needed?\",\"answer\":\"It is required for students with a known medical condition that needs intervention or could lead to a medical emergency requiring first aid or other care. It is not needed when the student already has a medical action plan specifically related to the diagnosis.\"},{\"question\":\"How should the plan be maintained over time?\",\"answer\":\"The plan must be reviewed annually or when the student’s medical condition changes, and parents/carers/guardians must inform the school immediately of changes that impact the form’s contents.\"}]","Student Medical Condition Plan - Pro-Forma | PDF",1789204691]