Medical Forms
All forms can be completed within Adobe Reader. Simply type in the fields and print out the completed form. Some forms will not allow you to complete
certain fields, as those must be filled out with a pen.
Download Adobe Acrobat Reader Here.
- Child's Pre-Admission Health History (PDF) (Lic 702)
- Physicians Report (PDF) (Lic 701 - must be signed by physician)
- Medical Statement to Request Special Meals and/or Accommodations (PDF) (CACFP)
- Nebulizer Care Consent (PDF) (Lic 9166) (To be completed for each child requiring inhaled medication while at the Center. A separate form must be completed for each person who administers inhaled medication to the child. Must be updated annually.)
- Child's Developmental Health History (PDF)
- Medication Authorization (PDF)
