Individualized Healthcare Plans for the school nurse has a pretty good CD as far as a general template with a big heavy manual goes. The book is pretty useful in helping you find the right wording and verbiage for your nursing diagnoses.
Since this is such a specialized issue you may want to contact that student's physicial directly to get fodder for your plan. (i searched too - probably didn't find anythnig different from you)
Found a great website link: http://www.aea267.k12.ia.us/schoolnu...?page=sn_forms
which has a nice digital template of ihp's and ep's and so forth.
is a great site as well.