Sketty Primary School Health Care Plan for Pupils with Medical Needs

Name:

Address:

Date of Birth:

Name of School:

Class/Form:

Medical Condition:

Date plan drawn up:

Review date:

CONTACT INFORMATION

Family Contact 1 Name:

Phone No: (work): (home): (mobile):

Relationship:

Family Contact 2 Name: Phone No: (work): (home): (mobile):

Relationship:

Family Contact 3 Name: Phone No: (work): (home): (mobile):

Relationship:

GP Name:

Phone No:

Clinic/Hospital Contact Name:

Phone No:

Describe medical condition and give details of pupil’s individual symptoms:

Daily care requirements (e.g. How will the school ensure the health care needs of the pupil are catered for and the pupil is safe within school?):

Follow up care:

Storage of Medication :

Who is responsible in an emergency (Please state if different on off-site activities)

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Describe what constitutes an emergency for the pupil, and the action to be taken if this occurs:

If If

Immediately Immediately

Health Care Professional…………………………………………… Date………………….

Parent/carer…………………………………………………………… Date………………….

Head teacher …………………………………………………………. Date…………………

ALNCO ………………………………………………………………….. Date…………………

I consent to the Healthcare Plan being copied to Senior Specialist Teacher – House, Ty Cwm, Cockett Road, Cockett, , SA2 OFJ and stored digitally.

Signed:

Parent / Carer…………………………………………………………… Date………………….

Sketty Primary School is the data controller for the personal information you provide on this form. Your information will be used to ensure your child’s health and medical needs are met whilst in our care. We will not share your data with any third parties without your explicit consent unless we are required or permitted to do so by law.

3 Data protection law describes the legal basis for our processing your data as one based on legal obligation, as we are required to understand the medical or other needs of our pupils in order to keep them safe from harm. For further information about how the school uses your personal data, please see our Data Protection Policy on our website https://sketty-primary-school1.j2bloggy.com/documents/policies/

I consent to the details within the Healthcare Plan (including a photograph of the child for recognition purposes) being shared with all staff within the school to ensure staff have the information they require to be able to respond appropriately.

Signed: ………………………………………………………….

Parent/Carer………………….………………….Date…………………

4 Staff Training Types Names and dates

Monitoring Record Comments Reviewed (Date)

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