2312 Chandawood Drive, Pelham, AL  35124-1229   *   FAX 205-621-2149   *   Telephone 205-663-7402


 


Home

HIP for Parents

HIP Topics

Downloadable Forms

Sample Activities

Growing Strong

Watch Me Grow

I Am Amazing

Services Offered

Training
 Packages


Order Forms

Links

ASHA Council

Healthy CHILDCare Magazine

Profile

 


SAMPLE FORMS FOR CHILDCARE PROGRAMS


The forms listed on this page are examples only! Content of each form is based on national recommendations and requirements, and sample forms from other childcare programs.

You are welcome to download these forms as "WORD" documents. The individual forms may not include all the information needed for your specific program. Please  carefully review all related Federal, state, and local requirements, as well as written policies for your program; then, you may modify these forms to meet the needs of your childcare program.

Other forms will be added.

 

Injury Reporting 
Administration of Medication
Document both parent authorization and administration of medication. 
Daily Health Check 
Caregiver should do a visual check of each child upon arrival and before the parent leaves. A child who appears to be ill may be sent home or to the doctor/clinic as appropriate.
Sample Emergency Poster 
This is an example of a poster to be used in Head Start or other childcare classrooms or homes. Individualize posters for each classroom or nursery. 
Community Assessment Questionnaire 
This questionnaire may be modified and used to collect data from the target population; resulting information may supplement other community assessment data. 

Emergency Supplies 
Most authorities recommend preparing for three or more days (72 hours). Begin with a basic list of supplies; then work with a team to review and complete the list so that all children’s needs are met. 

Sample forms on additional topics may be available. Contact Charlotte Hendricks for details.

 


©2000,2001,2002 - Child Health Online
Contact Dr. Charlotte Hendricks