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Get Cy 867 1993-2025
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How to fill out the CY 867 online
The CY 867 form is an essential document for providing emergency contact and parental consent information. This guide will help you navigate the form efficiently, ensuring you complete all necessary sections accurately.
Follow the steps to successfully complete the CY 867 form.
- Click ‘Get Form’ button to obtain the form and open it in the editor for completion.
- Begin by filling in the child’s name, birthdate, and address in the designated fields. This is important for identifying the child and ensuring accurate record-keeping.
- Next, enter the names and contact details of the mother/legal guardian and father/legal guardian. Include their home telephone numbers and business telephone numbers, along with the corresponding addresses.
- List emergency contact person(s) and ensure their names and telephone numbers are provided clearly. It is vital for ensuring swift communication in an emergency situation.
- Include the name of the child’s physician or medical care provider along with their contact number and address. This information is critical for obtaining emergency care if necessary.
- Document any allergies or special disabilities the child may have, as well as any medications or special conditions that should be noted.
- Fill in any additional medical or dietary information that may be necessary in an emergency situation. This helps in providing the best possible care.
- Enter the health insurance policy number or indicate if the child is covered by medical assistance benefits.
- Review the consent section, ensuring the parent or guardian signs next to each item to indicate consent for obtaining emergency medical care, administering minor first-aid, and participation in activities listed.
- Finalize the form by ensuring all required signatures are obtained, and dates are included. After completion, you can save changes, download, print, or share the form as needed.
Complete your CY 867 form online today to ensure your child's safety and well-being.
A medical release form for a daycare provider allows the daycare staff to make medical decisions or seek medical care for your child in emergencies. This form includes vital information such as your child's health conditions, medications, and emergency contacts. By incorporating CY 867, you can create a comprehensive medical release that not only meets daycare requirements but also ensures your child's health is prioritized.
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