Question 19
Statement from someone who knows the child.
If possible have this completed by your PDSN. It is not compulsory so if no-one suitable can complete this don’t be concerned by leaving it blank.
Question 20
Consent.
This asks if you agree to contact being made with your child’s healthcare team regarding your claim. Tick 'yes' or 'no'.
Question 21
About the child’s illnesses or disabilities.
List Type 1 diabetes and how long they have had it.
When answering what treatment they have, put everything they are prescribed including insulin, and specify if this is administered by injections or pump. Also include hypo treatments they are prescribed such as Glucagon or Glucogel.
Complete how often they require treatment as applicable for your child. For injections be sure to include any long-acting doses, along with injections at times relevant to eating and additional injections if required when blood glucose levels are high. For an insulin pump treatment is constant with extra insulin delivery at times relevant to eating and extra boluses required when levels are high.
If you have an up-to-date prescriptions list (and consumables list for a pump) send a copy with your claim.
Question 22
Aids and adaptations.
Children with diabetes generally do not require these. Tick the ‘no‘ box.
Question 23
Claiming under the special rules.
This is for children who have terminal conditions. Diabetes is not a terminal condition, tick 'no'.