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Ascension School - Diabetes Action Plan

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Dear Parent,

Attached is the 2026-2027 Diabetes Packet for you to print, complete, and return to school for the upcoming school year. It is important that the paperwork be on file by August 11, 2026.

Please bring medications and blood sugar testing supplies prior to the first day of school. Medications (insulin, glucagon, and glucose tablets) need ot be in their original containers, labeled with the child's name, and not to expire until the end of the school year. All medications need a signed physician's order. Medication orders may be faxed to +1-636-532-6502.

Should you have any questions, please feel free to contact the school office.

Thank you,

Gretchen Kirsch, RN BSN

Ascension School Nurse

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