Back School Sample 504 and IEP Plans

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Review of The Laws: Section 504 and the IDEA

Sample 504 Plans and IEPs From Our Readers

These sample 504 plans and IEPs are arranged by grade. Each is stored in Microsoft Word or PDF format. You are free to use these for your child or children.

Grade   Sample 504 Plans
(Age and Insulin Regimen)
  Plans from Outside the US
Pre-Kindergarten   Age 4, Injections
Age 5, Injections
Kindergarten   Age 5, Insulin Pump
Age 5, Insulin Pump
Age 5, Injections
Age 6, Injections
Age 6, Injections
Age 6, Injections
Age 6, Insulin Pump
Grade 1   Age 6, Insulin Pump
Age 6, Insulin pump and sensor
Age 6, Injections
Grade 2   Age 7, Insulin Pump    
Grade 3   Age 8, Injections
Age 8, Injections
Grade 4   Age 9, Insulin Pump
Age 10, Insulin Pump
Age 9, Injections
Grade 5        
Grade 6       Canada - Age 10, Insulin Pump
Grade 7   Age 12, Insulin Pump
Age 12, Insulin Pump
    (Teacher Handout)
  Canada - Age 12, Insulin Pump
Grade 8   Age 13, Injections
Age 13, Injections
Age 13, Insulin Pump
Grade 9        
Grade 10   Age 15, Insulin Pump
Age 16, Insulin Pump
Grade 11   Age 16, Insulin Pump
Grade 12   Age 17, Insulin Pump
College Entrance Exams   SAT Letter
Collection of letters for
SAT and ACT accommodations

(PDF and Word)

How To Share Your 504 Plan or IEP

To share your 504 Plan or IEP with other parents, please send an e-mail to Include the child's age, age at diagnosis, insulin regimen (MDI-syringe, MDI-pen, pump, etc.), state, and optionally the school district. Include the 504 Plan or IEP as a Microsoft Word document attachment.

Note for High School and Junior High School Students

High school and junior high students with diabetes can get special accommodations when taking standardized tests (e.g., PSAT, SAT, and ACT). These accommodations typically include "stop the clock" breaks for blood glucose testing, bathroom visits, or taking emergency glucose to treat low blood sugars. Diabetes is typically not a reason for additional time in taking a test, however. Testing organizations may require that students have a 504 plan on file before providing the accommodations. Parents and students are strongly encouraged to discuss this with guidance counselors at the beginning of each school year.

Presentations about Diabetes at School

Additional Resources

Updated August 4, 2014

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