Medical Condition Risk Minimisation Plan
Child’s Name:
     	Child’s Date of Birth:
     	
1.	What is the medical condition?
     
2.	Does the child require medication to be administered when they attend Outside School Hours Care?
 YES
 NO
3.	Does the child require dietary modifications?
 YES
 NO
4.	Does the child have a medical conditions Action Plan from a GP or Specialist?
 YES - Please supply a copy on enrolment.
 NO – If NO why do you not have one?      
If YES: Please give Medication Name and Dosage Required or Dietary Requirements (unsafe foods/meals), or description of diagnosed Medical Condition ?
     
What are the issues and/or the actual/potential situations that could lead to an emergency?
     
What can be done to reduce the risks? What resources are needed?
     
Who needs to be included in the process of transition at the service to ensure all areas and requirements are noted and understood?
     

Parent:      
Signature:      
Date:      
Management Name:      
Signature:      
Date: