For a current health or medical condition requiring child care staff to monitor the condition, provide treatment, care or to give medication, please complete JFS-01236 Child Medical/Physical Care Plan. Please fill out a separate form for each health/medical condition.

If the child’s health/medical condition listed on the “Medical/Physical Care Plan” requires the child care center to administer any of the following: prescription medication, non-prescription medication, a topical product or lotion, a food supplement, or anything else that needs to be administered/given by the child care center, please ALSO complete JFS-01217 Request for Administration of Medication.

Preschool Child Medical Statement to be filled out by parent and doctor. Child Medical Statement – JFS 01305.