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Pennsylvania Southeast Conference Fall Meeting, 2015 Child Care Medical Release Form (complete one per child) Name of Child: Birthdate of Child 1. Has this person had any medical problems of which
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Child care medical release is a document that gives permission to child care providers to seek medical treatment for a child in case of an emergency.
Parents or legal guardians of a child are required to fill out and file the child care medical release form.
Parents or legal guardians need to provide basic information about the child, emergency contacts, medical insurance details, and any known allergies or pre-existing medical conditions.
The purpose of child care medical release is to ensure that child care providers have the necessary permission and information to seek medical treatment for a child in case of an emergency.
Child's full name, date of birth, emergency contacts, medical insurance information, known allergies or pre-existing medical conditions must be reported on child care medical release.
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