Medical Condition Risk Minimisation Plan
Child’s Name:
     	Child’s Date of Birth:
     	
1.	What is the medical condition?
     
2.	Does the child require dietary modifications?
 YES
 NO
If YES, types of unsafe foods/meals?
     

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?
     

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