Individual Health Care Plan (IHCP) Information
We are implementing a central system to hold the information linked to the medical needs of our students.
This form is designed to help us maintain a high level of care and support for a student with medical needs.
All types of conditions need to be included where a diagnosis was made or has been made recently.

 This form can be filled in for a person with many different types of medical needs and it may include asthma, allergies,  a life-long and/or developmental condition, or when undergoing a mid-term or long term treatment for a  specific condition,  or in the case of recovering from a long term illness which continues impacting on life and where the medical professionals continue being regularly involved.
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Student's Full Name:  *
Date of Birth:  *
Person filling in this form: full name *
Relationship to the student: *
I have the parental responsibility *
Year Group *
Medical Conditions: Known Conditions (diagnosis / name of condition/s of your child that we need to be aware of; list all of them) *
Medical Conditions: Associated Professionals (leave blank if not relevant; information you want us to have or you know: name/contact detail/organisation)
Medical Conditions: Key Staff (if known; leave blank if unknown)
Medication: What is taken in school? (leave blank if not relevant) 
Medication: Who has access? (leave blank if not relevant; this is mainly if the student carries this, such as an EpiPen or if it in a medical room stored, etc.)
Medication: Does it need to be monitored? (generally, we do not usually keep that type of medication on the premises unless exceptionally important; leave blank if not relevant)
Medication: Does medication have side effects? (leave blank if not relevant)
Medication: Does medication affect behaviour/learning?  (leave blank if not relevant)
Times of the Day: Arrival (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if nothing relevant to share)
Times of the Day - Lessons 1-2 (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if nothing relevant to share).
Times of the Day - Morning Break (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if nothing relevant to share).
Times of the Day - Lessons 3 - 4 (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if nothing relevant to share).
Times of the Day - Break 2 - Lunch (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if nothing relevant to share).
Times of the Day - Lesson 5 - End of Day (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if nothing relevant to share).
Times of the Day  - After School Clubs (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if nothing relevant to share).
Times of the Day - Care at Meal Times  (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if not relevant).

Times of the Day - During Physical Activities  (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if not relevant).

Times of the Day - Trips away from school (This is to get an insight what this may look like for the student/ or if support or adjustments need to be maintained during the day at specific times, etc. Leave blank if nothing relevant to share).

Schedule: medication - dose / when? / why? / how? who?
Emergency Situation: What is an emergency?
Emergency Situation: What are the signs/symptoms?
Emergency Situation: What are the triggers?
Emergency Situation: What action must be taken?
Environment and SEMH (Social - Emotional - Mental and Health needs): Absence from School
Environment and SEMH (Social - Emotional - Mental and Health needs): Process for catching up 
(If not known yet, you may put suggest something or ask to discuss this further. If not relevant, leave blank.)
Environment and SEMH (Social - Emotional - Mental and Health needs): Adaptations to environment 
(Please fill in although already known to school and in place; it is good to check that this is still needed; if not relevant, please le us know; if it is already included on the SEND Student  passport or an EHCP, you can refer to it.)
Environment and SEMH (Social - Emotional - Mental and Health needs): 
Do they need to leave the classroom?
(please fill in although already known to school and in place; it is good to check that this is still needed; if not relevant, please le us know; if it is already included on the SEND Student  passport or an EHCP, you can refer to it.)
Environment and SEMH (Social - Emotional - Mental and Health needs): 
Rest Periods? 
(please fill in although already known to school and in place; it is good to check that this is still needed; if not relevant, please le us know; if it is already included on the SEND Student  passport or an EHCP, you can refer to it.)
Buddy: is there a need for a buddy to assist/accompany? 
Parent contribution: (Anything else you would like the school and people working with the young person to know) *
Student contribution: (Anything else you would like the school and people working with the you to know) *
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