Forms

Download any of the following Child Care forms to use with your program.

Provider Forms

  1. Admission and Arrangement Form 9-2019 (PDF)
  2. Alcohol Drug Use Policy fillable form (PDF)
  3. Allergy Information Form 10-2017 (PDF)
  4. Background Study Documentation Form (PDF)
  5. Checklist for Children's Records (PDF)
  6. COVID-19-preparedness-plan-optional-template 6-19-20
  7. Crib Safety Inspection form 06 2014 (PDF)
  8. Daily Attendance Record 8 2015 (PDF)
  9. Emergency Preparedness Plan
  10. Enrollment Form (PDF)
  11. Enrollment Form Interactive Version 2014 (PDF)
  12. Fire and Storm Drill Log and Floor Plan (PDF)
  13. Freedom to Breathe Sample 6 17 2014 (PDF)
  14. General Training Record (PDF)
  15. Grievance Policy fillable form (PDF)
  16. Immunization Record MDH 2019.pdf
  17. Liability Insurance Notice to Parents Guardians 8 2018 (PDF)
  18. License Capacity Breakdown (PDF)
  19. Mandated Reporter Policy (PDF)
  20. Notice of Privacy Practices form (PDF)
  21. Parental Acknowledgement (Infant Rolling Over) SAMPLE (PDF)
  22. Parental Consent (Swaddling) 6 2018 (PDF)
  23. Permission to Administer Non-Prescription and Prescription Meds (PDF)
  24. Permission to Take Child on Field Trips (PDF)
  25. Photo Release
  26. Physicians Directive for Alternative Infant Sleep Position (PDF)
  27. Reduced Fee Form 2019 (PDF)
  28. Rule Summary for Parents-DHS March 2015 (PDF)
  29. Sample Policy (PDF)
  30. Serious Injury Reporting Form DHS-7774-ENG 3-20
  31. Substitute Tracking Log
  32. Swimming Pool Permission
  33. Training Record (PDF)
  34. Trampoline Permission (PDF)
  35. Travel and Activity Authorization
  36. Variance Forms Combined DHS-7297 (open with Internet Explorer)
  37. Variance Forms Combined (non-fillable) 7297-ENG
  38. Wading Pool Permission (PDF)