Tonic/ tonic Care plan attached Well Absence clonic/ Epilepsy Needs medication controlled seizure unclassified after minutes seizures Additional Gastrostomy Gastrostomy NG Tube Tracheostomy tubing button peg Hearing/ Hearing Registered visual Grommets Glasses aids/device difficulties Muscle tone High Low Spasms Dystonia Skin Skin Eczema Chlorine allergy Verrucae conditions infection Weight in Swallowing Diabetes Incontinence excess of 160kg difficulties Use of Other Others thickeners Allergies If any family members or carers attending the Hydrotherapy Pool sessions have any medical problems or health conditions, please specify Family member Medical problem / Health condition Mobility: Swimming ability: Beginner Intermediate Advanced Independent Session Dates & Times:
Epilepsy Well controlled Absence seizure Tonic/ tonic clonic/ unclassified seizures Care plan attached Needs medication after minutes Additional tubing Gastrostomy button Gastrostomy peg NG Tube Tracheostomy Hearing/ visual difficulties Grommets Hearing aids/device Glasses Registered Muscle tone High Low Spasms Dystonia Skin conditions Eczema Skin infection Chlorine allergy Verrucae Other Diabetes Incontinence Weight in excess of 160kg Swallowing difficulties Use of thickeners Others Allergies If any family members or carers attending the Hydrotherapy Pool sessions have any medical problems or health conditions, please specify Family member Medical problem / Health condition Mobility: Swimming ability: Beginner Intermediate Advanced Independent Session Dates & Times:
EasterSwim2018.docx