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Sep
27

Health forms and care plans

The following forms are organized alphabetically. The forms that may be applicable for each health condition are linked below.

Please note that many care plan forms commonly used by healthcare providers do not meet WAC requirements for child care and early learning programs. The purpose of the Care Plan Checklists are to ensure that the care plan you have on file for a child meets WAC 110-300-0250 and 110-300-0300.

Health Care Plans

Allergy Care Plan

Asthma Care Plan

Diabetes Care Plan

Food Intolerance Care Plan

Individual Care Plan

Seizure Care Plan

Medication and Care Plan

Medication Forms

These forms are intended to be used for medications that are not a part of a care plan.

  • Medication Authorization Form (117 Kb)

    Used for medications that will be given by child care or early learning program staff to a child during care.

  • 3-Day Critical Medication Authorization Form (113 Kb)

    Used for medications that a child regularly takes at home and is lifesaving. A child care or early learning program must have a 3-day supply of these medications in case of an emergency that requires the child to remind in care past usual hours.

Non-Medication Authorization Forms

Hand Lotion Authorization Form

Hand Sanitizer Authorization Form

Toothpaste From Home Authorization Form

Toothpaste Authorization Form (Program-Provided/Bulk Toothpaste)

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