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Office of Early Learning and School ReadinessChild Medical Statement This form must be completed by a Medical Professional and returned with a copy of children immunization records, by the first day
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How to fill out child medical statement

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How to fill out child medical statement

01
Request for a child medical statement form from the school or doctor's office.
02
Fill out all personal information about the child including name, date of birth, and address.
03
List any known allergies or medical conditions that the child has.
04
Include emergency contact information in case of any medical issues.
05
Sign and date the form to verify the accuracy of the information provided.

Who needs child medical statement?

01
Parents or guardians of school-aged children.
02
Summer camp organizers.
03
Sports coaches or instructors.
04
Childcare providers or babysitters.
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Child medical statement is a document that contains information about a child's medical history, current health status, and any ongoing medical treatment.
Parents or legal guardians of the child are required to file the child medical statement.
Child medical statement can be filled out by providing accurate and detailed information about the child's medical history, current health status, and any ongoing medical treatment. It may require input from healthcare professionals.
The purpose of child medical statement is to inform schools, daycare centers, and other childcare providers about the child's medical needs and to ensure appropriate care and support.
Information such as the child's medical history, current health status, allergies, medications, immunization records, and any chronic conditions must be reported on the child medical statement.
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