Benignus Clinic
Rss Icon
Email
Diabetes in the School Setting
I have reviewed and understand the information
I have reviewed the information and will contact the nurse for additional concerns
Universal Precautions
I have reviewed and understand the information
I have reviewed the information and will contact the school nurse for additional information
HIPPA and FERPA
I understand that all information regarding student's medical conditions or problems are confidential and may not be discussed with anyone not directly involved with the student.
Please Check
I have completed Universal Precautions, Diabetes, and Anaphalaxis Training for the 2015-2016 school year.
First Name:
Last Name:
Grade/Department: