The decision to send our children back to in-person school or whether to enroll in virtual learning is difficult at this time; making this decision is even more complicated if your child has an underlying medical condition. As a school counselor who works closely with kids with life-long medical conditions\u2014specifically rare bleeding and blood disorders\u2014I am often asked how I help students and families prepare ahead of the school year. In typical, non-pandemic times, returning to school raises specific concerns to families whose school-aged children have health circumstances: Will the school nurse know how to administer my child\u2019s medication? Will the nurse or teacher recognize signs and symptoms of concern? Will the teacher understand my child needs a water bottle at their desk throughout the day? Will my child\u2019s frequent restroom needs be met? Should we pursue a 504 plan or an Individualized Education Plan (IEP) if my child\u2019s chronic health condition can result in attendance issues? On top of these concerns, the addition of a global pandemic adds a layer of health risks and social and emotional complexities, making this year a very challenging time for families and children. Consult with your child\u2019s healthcare providers(s) The decision for in-person instruction versus virtual learning is a very personal one that requires consultation with your child\u2019s healthcare provider(s); your child\u2019s healthcare provider(s) have the most complete understanding of your child\u2019s condition(s) and can help you weigh the health risks of COVID-19 in group settings against the social\/emotional and educational benefits of in-person instruction. Your school\u2019s COVID-19 safety plan also provides an important piece of information; you should share your school\u2019s plan with your healthcare provider(s). Knowing the guidelines your child\u2019s school plans to implement to prevent the spread of the virus helps your child\u2019s healthcare provider(s) make an individualized recommendation. Ask your healthcare provider(s) to make available a written health plan\u2014a set of directives regarding a plan of care for the school year. In-person learning considerations for children with medical challenges If at any point in the year you consider sending your child back to a physical school building for in-person learning (with your doctor\u2019s approval): \tReview your school\u2019s COVID-19 safety guidelines with your child; discuss why the guidelines have been developed and the importance of following them including the consequences if they are not followed \tProvide your school with a copy of your healthcare provider(s) written health plan, as noted above \tDetermine if your school has a full-time nurse and ask who covers medical needs at your child\u2019s school \tHave the school develop an Individualized Health Plan (IHP) with your collaboration; also discuss implementation of a Section 504 plan or assessment for an Individualized Education Plan (IEP) with school staff to support your student\u2019s unique learning needs \tEnsure your child remembers to wear or carry their medical ID each day; obtain one if they do not already have one \tTalk with your child about how to advocate for their needs in school \tConsider health hazards and ways to encourage and support school attendance and participation Virtual learning considerations for children with medical challenges \tIt is important to address the needs of your child through a Section 504 or an IEP even if you choose a virtual learning environment so that your child\u2019s learning needs will be met in light of their chronic medical condition \tWork closely with school staff to give your child the best opportunity to be as engaged as possible with the classroom learning and their peers in the virtual environment (i.e. necessary technology equipment, clear lines of communication, virtual participation alternatives) \tValidate your child\u2019s concerns and frustrations about not being with peers at school; be creative to help your child socially engage with peers \tBe prepared to provide documentation from your child\u2019s healthcare provider(s) if it is determined that virtual learning is the most appropriate choice given your child\u2019s underlying medical condition This school year, there are more variables to consider than ever before\u2014an especially poignant reality for parents of children with chronic medical conditions. These important family decisions can only be made by examining all the facts and having frank and open conversations with all stakeholders\u2014including your child\u2014about what is best at this time. It is also important to speak to your school counselor or social worker about how your student\u2019s mental health needs are addressed. You can also reach out to an advocacy group for further support to obtain the necessary education accommodations for your child. A list of advocacy groups can be found on the Indiana Department of Education website (www.doe.in.gov). Brenda McLean is a school counselor with the Indiana Hemophilia and Thrombosis Center (IHTC) who helps school-aged patients and their families navigate education settings with their health concerns in mind. Brenda also works directly with school staff and administration to help advocate for children\u2019s unique needs in the school setting.