CHILDCARE INSTRUCTION WORKSHEET
This document is provided by our friends at OverDrive Systems, Inc. For more information and legal documents, visit OverDrive System's web site at http://www.bookaisle.com.
About This Form
The childcare instructions is not a formal document. It is a worksheet to document instructions and organize information for childcare providers. Sections include information for medical and dental providers, special needs of children, children's schedule and activities. This instructions should be left with the child care provider to provide complete information about your children.
These instructions contain information to allow the care provider in your absence to know important information about your children. The detail information on your child's/children's likes and dislikes will assist the provider in giving quality care in your absence.
Worksheet
On what date do you intend to send this letter?What is your name?
Are you married or single?
What is your spouse's name?
What is your street address?
What is your city, state, and zip code?
What is your home telephone number?
What is the location where you can be reached in case of an emergency?
What is the telephone number of the location where you can be reached in case of an emergency?
Do you have a pager?
What is your pager number?
Do you have a cellular phone?
What is your cellular phone number?
What are your children's names and dates of birth?
Describe the activities that should take place while you are out.
Describe any activities that you would prefer not to take place while you are out.
Please list all allergies that the childcare provider should be aware of.
Describe all foods that you would consider to be acceptable for your childcare provider to serve.
Describe all foods that you prohibit your childcare provider to serve.
What time should your childcare provider consider to be bedtime?
Do you have one child or more than one child?
What is the name of the Doctor to contact in case of an emergency?
What is the name of the Dentist to contact in case of an emergency?
What is the name of the hospital that you prefer for emergency care?
What is the name of your medical insurance carrier?
What is your medical insurance policy number?
What is the name of the person to call if you cannot be reached in case of an emergency?
What is the relationship of the person to be contacted if you cannot be reached in case of an emergency?
What is the telephone number of the person to contact if you cannot be reached in case of an emergency?
What is the telephone number of the local police station?
Be sure to enter the area code as well as the telephone number.
What is the telephone number of the local fire station?
What is the telephone number of the local poison control center?
Copyright © 1997 OverDrive Systems, Inc.
Important Notice: This document and information is provided to assist and educate you regarding personal legal matters. Your use of this material does not create an attorney-client relationship with Court TV or OverDrive Systems, Inc. Be aware that procedures and laws vary from state to state and may change. You are advised to seek the advice of an attorney regarding any issues or questions you have regarding your own personal situation. Neither OverDrive Systems, Inc., nor Court TV represent or warrant that the document you create using any of this material will lead to the result you desire and therefore are not responsible for any liability for your use of this material.
