Get Dhr-cdc-739 2001

The DHR-CDC-739 form is essential for documenting a child’s preadmission information required by child care facilities. This guide will assist you through the process of filling out the form online, ensuring that all necessary details are accurately provided for a smooth enrollment experience.

Follow the steps to complete the DHR-CDC-739 form online:

1. Press the ‘Get Form’ button to access the DHR-CDC-739 form and open it in your preferred online editor.
2. Begin by entering the child’s name in the designated field, along with the name they are commonly known by.
3. Provide the child’s birthdate, home address, and the names of the parent(s) or guardian(s) responsible.
4. Fill in the home telephone number and the address of the parent(s) or guardian(s). Include the mother’s and father’s employer details, such as the employer's name and address.
5. List employer telephone numbers, including options like pagers or cellular devices, for quick contact.
6. Detail the instructions on how to reach the parent or guardian in case of an emergency.
7. Identify the person(s) to contact in an emergency if the parent(s) or guardian(s) cannot be reached, including their names and relationship to the child.
8. Provide the child’s doctor’s name, address, and telephone number for medical references.
9. Fill out the emergency authorization section to grant permission for emergency medical treatment and transportation, ensuring to sign and date this section.
10. Describe any special needs or instructions for the child in the provided space.
11. List the person(s) to whom the child may be released, ensuring to include their names, relationship to the child, address, and telephone number.
12. Acknowledge the lack of inspection for activities away from the facility by signing and dating this section.
13. Provide consent for the child’s participation in various activities by circling 'yes' or 'no' for transportation, swimming, or wading activities, followed by signing and dating as required.
14. Complete the section designated for the facility's staff, noting the child’s first day of attendance and withdrawal date.
15. After completing all sections of the form, ensure to save changes, download, print, or share the document online as needed.

Complete the DHR-CDC-739 form online for your child's enrollment today.