Get Iccpp For Allergies - Cook County Ymca

This guide provides comprehensive instructions on how to fill out the Individual Child Care Program Plan (ICCPP) for Allergies for the Cook County YMCA. By following these steps, you will ensure that your child’s specific allergy needs are clearly communicated and properly managed.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in your child’s name in the designated field, including first, last, and middle names, followed by their birthdate.
3. Indicate any allergies your child may have by providing detailed information in the 'Allergy To' section.
4. Specify whether your child is asthmatic by selecting 'Yes' or 'No'. If ‘Yes,’ note that this indicates a higher risk for severe reaction.
5. Describe the allergy symptoms your child experiences when exposed to either food allergens or allergy triggers.
6. Outline the treatment or medication details your child requires when exposed to an allergen, including type and dosage.
7. Detail asthmatic symptoms and causes that your child experiences in the relevant section.
8. Indicate the treatment for asthmatic episodes, including specifics on medication and dosage.
9. Fill out the emergency contact information, ensuring that the phone numbers for both parents or guardians are included.
10. State medical provider information, including the primary health provider's name, clinic, and phone numbers for all applicable specialists.
11. Authorize the YMCA staff to obtain emergency medical care by marking 'Yes' or 'No' for the provided authorization options.
12. Complete the specific allergy action plan by checking the appropriate boxes related to staff training and precautionary measures.
13. Provide your signature, printed name, and date in the designated parent/guardian signature field. Review the form for completeness.
14. Upon completion, you may save your changes, download the form, print it, or share it as needed.

Ensure your child's allergy management is well-documented by completing the ICCPP form online today.