Get Medical Statement Of Child In Childcare - University At Buffalo Child ... - Ubccc Buffalo

This guide provides a comprehensive walkthrough for completing the Medical Statement of Child in Childcare form for the University at Buffalo. Aimed at ensuring your child meets necessary health requirements, this form must be filled out accurately and thoroughly.

Follow the steps to complete the form successfully

1. Click ‘Get Form’ button to access the Medical Statement of Child in Childcare form and open it in the required editor.
2. In the first section, enter the child's name, date of birth, and date of examination. These details identify the child and ensure accurate record-keeping.
3. Next, navigate to the immunization section. Fill in the required dates for each immunization received, including MMR, Varicella, DTaP, IPV, Hib, and Hepatitis B. If applicable, include exemptions and the certification for any immunizations that cannot be administered.
4. Under the tests section, document the tuberculin test date and results. Remember to include whether the results were positive or negative, and provide results for lead screening tests required by New York State law.
5. In the health specifics section, indicate any allergies, medications regularly taken, special diet requirements, or health conditions that require special attention. Be sure to add relevant comments to clarify any health-related concerns.
6. Complete the summary of the physical exam. The examiner must affirm that the child is free from contagious diseases and able to participate in daycare.
7. Finally, the examiner should sign and provide their contact details, including name, title, address, and phone number to validate the statement.
8. After completing all sections, save your changes. You can then download, print, or share the completed form as necessary.

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