Forms

Download any of the following Child Care forms to use with your program.

Provider Forms

  1. Optional Form for Parent Statement: Infant Less Than Six Months of Age Regularly Rolling Over
  2. Admission and Arrangement Form 9-2019 (PDF)
  3. Alcohol Drug Use Policy fillable form (PDF)
  4. Allergy Information Form 7-2017 (PDF)
  5. Background Study Documentation Form (PDF)
  6. Checklist for Children's Records (PDF)
  7. COVID-19-preparedness-plan-optional-template 6-19-20
  8. Cradleboard Variance Request Form 1-24
  9. Crib Safety Inspection form 06 2014 (PDF)
  10. Daily Attendance Record 8 2015 (PDF)
  11. Data Privacy-Tennessen Notice
  12. Directive for Alternative Infant Sleep Position 1-24
  13. Emergency Preparedness Plan
  14. Enrollment Form (PDF)
  15. Enrollment Form Interactive Version 2014 (PDF)
  16. Fire & Storm Drill Log and Floor Plan with Sample (PDF)
  17. Freedom to Breathe Sample 6 17 2014 (PDF)
  18. General Training Record (PDF)
  19. Grievance Policy fillable form (PDF)
  20. Helmet Approval for Sleeping Infants 1-24
  21. Immunization Record MDH 2019.pdf
  22. Liability Insurance Notice to Parents Guardians 8 2018 (PDF)
  23. License Capacity Breakdown (PDF)
  24. Maltreatment of Minors Mandated Reporting
  25. Parent Cradleboard Request 1-24
  26. Permission to Administer Non-Prescription and Prescription Meds (PDF)
  27. Permission to Take Child on Field Trips (PDF)
  28. Photo Release
  29. Rule and Statute Summary Family Child Care DHS-7747-ENG 10-20
  30. Sample Policy (PDF)
  31. Serious Injury Reporting Form DHS-7774-ENG 3-20
  32. Substitute Tracking Log
  33. Swaddling Consent for an Infant 1-24
  34. Swimming Pool Permission
  35. Training Record 2020 Licenseholder Co-Applicant 2nd Adult
  36. Trampoline Permission (PDF)
  37. Travel and Activity Authorization
  38. Variance Forms Combined (non-fillable) 7297-ENG
  39. Variance Forms Combined DHS-7297
  40. Wading Pool Permission (PDF)