ELC FORMS

REQUIRED FORMS:
General Health Appraisal Form - must be completed by child care provider and parent.

Immunization Form - must be completed by child care provider.

OPTIONAL FORMS:
Medical Administration Form - must by completed by parent and child care provider. This form is only needed if you’d like to provide the office with over-the-counter medication (such as Tylenol, cough drops, or vitamins).

Allergy and Anaphalaxis Emergency Care Plan - must by completed by child care provider and signed by parent. This form is only needed if you’d like to provide your child an Epi-pen or epinephrine auto-injector, at school.

Asthma Emergency Care Plan - must by completed by child care provider and signed by parent. This form is only needed if you’d like to provide your child an Albuterol inhaler at school.