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Yakima School District Policy and Procedures 3418.1X Page 1 of 2 INDIVIDUAL HEALTH CARE PLAN (ICP) Student Parent(s)/Guardian(s) Address Parent(s)/Guardian(s) Address Grade Emergency Contact 1 Emergency
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How to Fill Out the Form for Parents/Guardians of:

01
Start by gathering all the necessary information and documents. This may include the child's birth certificate, identification documents of the parents/guardians, and any legal custody or adoption papers if applicable.
02
Begin filling out the form by providing your personal details. This typically includes your full name, date of birth, current address, phone number, and email address. Make sure to double-check the accuracy of the information.
03
Specify your relationship to the child. If you are a parent, indicate whether you are the biological parent, adoptive parent, or legal guardian. Provide any relevant details about custody arrangements if necessary.
04
Provide information about the child. This includes their full name, date of birth, and any other identifying information required on the form. Double-check the accuracy of this information as well.
05
In some cases, the form may ask for additional details about the child's medical history, educational background, or special needs. Fill out this section accurately, including any relevant information that may be required.
06
If the form requires it, provide details about any other individuals who may have legal rights or responsibilities for the child. This could include step-parents, grandparents, or other legal guardians.
07
Sign and date the form once you have completed all the necessary sections. Make sure to review the form thoroughly before submitting it to ensure all information is correct and complete.

Who needs to fill out the form for Parents/Guardians of:

The form for Parents/Guardians of is typically required to be filled out by individuals who have legal rights or responsibilities for a child. This includes both biological and adoptive parents, as well as legal guardians who have been granted custody of the child. It is important that all primary caregivers with legal authority over the child complete this form accurately and thoroughly.
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The form is used to appoint a guardian for a minor child in case the parents are unable to care for them.
Parents or legal guardians of a minor child are required to file the form to appoint a guardian for the child.
To fill out the form, you need to provide information about the child, the proposed guardian, and the reasons for appointing them.
The purpose of the form is to ensure that a suitable guardian is appointed to care for a minor child in case the parents are unable to do so.
Information such as the child's name, date of birth, the proposed guardian's name, relationship to the child, and reasons for appointing them must be reported on the form.
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