Forms for Education

For Parents and Patients

Medical Home to School Summary Form ( 40 KB)
Sample form for communication between health care providers and schools about health concerns that impact a student's education.

Medical Home - School Information Release Form ( 49 KB)
Sample form for a child's parent/guardian to authorize two-way communication between the health care provider and school team.

Accommodating Children with Special Dietary Needs in the School Nutrition Programs ( 849 KB)
Gives a useful guide for nutrition accommodations, including information about modifying school meals for students with disabilities and other dietary requirements such as food allergies. The site includes a sample Eating and Feeding Evaluation form to be completed by the child's parent and physician and a sample Information Card for use by school food service staff in preparing meals for the child. From the U.S. Department of Agriculture Food and Nutrition Service.

School Contacts Page 1 (Care Notebook) ( 66 KB)
A place to list the school district, special education coordinator, 504 Accommodation Plan coordinator, district nurse for the school, care provider, and school/preschool. This is part of the Care Notebook Contacts Section.

School Contacts Page 2 (Care Notebook) ( 62 KB)
A form to list the school principal/administrator, classroom teacher, resource instructor, aide/assistant/intervener, special education director, special education teacher, therapists, and other contacts. This is part of the Care Notebook Contacts Section.

Building Your Care Notebook (AAP)
The American Academy of Pediatrics provides a central place with links to several forms from many states. For families that are new to making care notebooks, we suggest you pick one form and try filling it out before downloading other forms.

P.R.O. Filer Personal Portfolio & Filing System ( 160 KB)
Provides file dividers for the documents at the link above. Published by the Institute on Community Integration. See the companion Personal Portfolio Manual. For more tools, see the All Means All School-to-Work web site at http://ici.umn.edu/all/.

Personal Portfolio Manual ( 151 KB)
P.R.O. filer - Personal Portfolio and Filing System (2000) gives a helpful guide to organizing documents for youth and young adults with disabilities.. Published by the Institute on Community Integration. See the companion P.R.O. Filer Personal Portfolio & Filing System.