I had started the process of having one, but then the meeting itself kept getting delayed by one thing or another (not this meeting-related, other school stuff the principal couldn't miss). I have a great relationship with every teacher that comes in contact with Ella and have no doubt that in any event they will follow the plan I have documented. Each teacher also has her own "low kit" for times Ella cannot make it up to the nurse. In talking with my endo he told me that they are not necessary unless the school is not cooperating. I had a great conversation with the vice principal and unless I smell trouble (for lack of a better term) I will keep it that way. Middle school may be different But I'm very pleased right now and wondering if anyone else is in the same boat?