AF Form 3416: Download AF Child & Youth Blood Glucose Chart – Air Force families with children or youth diagnosed with diabetes rely on structured support in Child and Youth Programs (CYP). AF Form 3416, officially titled the CYP Glucose Chart (or AF Child and Youth Blood Glucose Chart), serves as a key tool for safely monitoring blood glucose levels during program hours.
This simple, standardized form helps staff document readings at key times of the day, ensuring consistent care and quick response to highs or lows. It pairs with AF Form 3417 (Air Force Child and Youth Diabetes Care Plan for Blood Glucose Testing) to meet the needs of children with diabetes in Department of the Air Force CYP settings.
What Is AF Form 3416?
AF Form 3416 is an official U.S. Air Force form used in Child and Youth Programs to log blood glucose (blood sugar) measurements. Released on September 6, 2016 (AF Form 3416, 20160906), it remains the current version and is prescribed by DAFI 34-144 (Department of the Air Force Instruction on Child and Youth Programs), last comprehensively updated in recent years.
The form includes fields for:
- Child/Youth’s Name
- Date
- Staff Initials
- Time slots/columns: Morning, Lunch, Afternoon, Other
- Space for required actions or comments if needed
It features a straightforward table layout for multiple daily entries, making it easy for trained CYP staff to record readings consistently.
Download the official AF Form 3416 PDF here: https://static.e-publishing.af.mil/production/1/af_a1/form/af3416/af_3416.pdf
You can also find it on the official Air Force e-Publishing website.
Why AF Form 3416 Matters for Air Force Families?
Department of the Air Force Child and Youth Programs (including Child Development Centers, School Age Care, and Family Child Care) must accommodate children with special health needs, including diabetes. DAFI 34-144 requires specific protocols for diabetes management to support mission readiness while prioritizing child safety and inclusion.
Key requirements include:
- Trained CYP personnel who can perform glucose testing and respond to abnormal levels or emergencies.
- Use of AF Form 3416 to document every blood glucose check.
- Completion of AF Form 3417 by parents/guardians, which provides authorization, specific care instructions, target ranges, and emergency protocols. This form is updated annually.
- Documentation kept in the child’s CYP file for continuity of care.
This system ensures staff test at consistent times (e.g., morning, before/after lunch, afternoon) and follow individualized plans, reducing risks during care hours.
How to Use AF Form 3416?
- Parent/Guardian Role: Provide the completed AF Form 3417 (Diabetes Care Plan) with physician input. Clearly note the child’s target blood glucose ranges, symptoms to watch for, and actions for hypo- or hyperglycemia.
- CYP Staff Role: Trained staff perform finger-stick tests (or follow Continuous Glucose Monitor protocols where applicable) and record results on AF Form 3416. They initial each entry with the date, time, and any required actions.
- Frequency: Testing typically occurs at set times aligned with the daily schedule (morning arrival, lunch, afternoon) plus “as needed” for symptoms, activity, or per the care plan.
- Storage: Records stay in the child’s confidential file.
CYP staff receive annual training from medical specialists on glucose monitoring, recognizing highs/lows, and administering emergency medication (such as glucagon) when authorized.
Blood Glucose Targets for Children and Youth (General Guidance)
Specific targets come from the child’s healthcare provider and AF Form 3417 — not the glucose chart itself. According to the American Diabetes Association (ADA) Standards of Care in Diabetes (2025/2026), common goals for most children and adolescents with type 1 diabetes include an A1C target of <7% (<53 mmol/mol), individualized based on hypoglycemia risk, technology access, and other factors.
Typical pre-meal or fasting targets for youth with diabetes often range from approximately 70–180 mg/dL, with adjustments for age, but always follow the personalized plan. Hypoglycemia is generally treated below 70 mg/dL. CYP programs emphasize prompt recognition and response to prevent emergencies.
Parents should work closely with their child’s pediatric endocrinologist or diabetes care team to define safe ranges for program hours.
Related Forms and Resources
- AF Form 3417: Diabetes Care Plan for Blood Glucose Testing (authorizes testing and details the individualized plan).
- DAFI 34-144: The governing instruction for all Air Force Child and Youth Programs.
- Official source for forms: Air Force e-Publishing.
Additional support is available through installation CYP offices, School Liaison Officers, and TRICARE-covered diabetes management services.
Tips for Air Force Parents
- Update care plans annually or whenever the child’s needs change.
- Ensure emergency supplies (glucose tabs, glucagon, etc.) are provided and current.
- Communicate openly with CYP staff about the child’s routine, technology (e.g., CGM), and any recent changes in management.
- Review ADA Standards of Care or consult your child’s diabetes team for the latest evidence-based guidance on youth diabetes management.
Proper use of AF Form 3416 contributes to safer, more inclusive care so military families can focus on readiness and well-being.
Need the form right now?
Direct download: AF Form 3416 PDF
For questions about enrollment or accommodations, contact your local Air Force Child and Youth Program or visit dafchildandyouth.com.
This article is for informational purposes only and is not a substitute for official guidance or medical advice. Always refer to current DAFI 34-144, your installation CYP policies, and your child’s healthcare provider for personalized diabetes management.