Sorry, you need to enable JavaScript to visit this website.

osse

Office of the State Superintendent of Education
 

DC Agency Top Menu

-A +A
Bookmark and Share

Health Form Requirements for Child Care Attendance

Review this page to ensure your child is ready for a healthy experience at child care. If you have specific questions about health form requirements, please talk with the child development facility your child attends or plans to attend.

 

Healthy bodies and minds are the foundation of academic success. Immunizations and regular visits to the doctor help protect a child’s health and readiness to learn. Children enrolled in a licensed child development facility in the District of Columbia are required to submit a Universal Health Certificate and certification that the child is up to date on their immunizations to the facility prior to the child’s first day of services and at least annually thereafter. Additionally, children age 3 and older are required to submit an Oral Health Assessment to the facility prior to the child’s first day of services and annually thereafter (5A DCMR § 152.1). Individual child care facilities may also have additional requirements beyond what is listed on this page, so please reach out to your facility with any questions.

 

Childhood Immunizations

Immunizations are the best defense against infectious diseases impacting children. To prevent the spread of infectious diseases, all children must be fully immunized before entering child care, unless exempted (5A DCMR §§ 152.1-152.13). The following groups may receive exemption from immunizations:

  • Children whose parent(s) or guardian(s) object on religious grounds.
    • The parent(s) or guardian(s) shall provide documentation to the child development facility stating that they have a good faith religious objection to immunizing their child. The parent(s) or guardian(s) may request and submit the religious exemption form by contacting DC Health using these instructions.
  • Children whose medical condition requires that immunizations not be given or for whom immunization is determined not to be medically advisable.
    • The child’s parent(s) or guardian(s) shall provide documentation from the child’s licensed health care provider stating that because of a medical condition, the child should not receive a particular immunization. Medical exemptions may be temporary or permanent, depending on the conditions specified by the child’s licensed health care provider. Health care providers may use the Universal Health Certificate to indicate medical exemption or submit a signed or stamped statement or letter indicating the immunization(s) are medically inadvisable.

Take steps now to ensure your child is caught up on all their required immunizations. More resources are available below.

FIND A FREE VACCINATION OPPORTUNITY NEAR YOU!

Visit the DC Health Immunization webpage for information on pediatric vaccine locations.

If your family needs access to health insurance, please visit the DC Health Link website or contact the Citywide Call Center by dialing 3-1-1. For more information on benefits available to children enrolled in DC Medicaid, including vision services and dental services, please see DC Health Check.

Annual Child Health Forms

Parents and guardians are required to ensure completion and submission of the following health forms to their child care facility before the child begins services at the facility and each year thereafter (5A DCMR § 152.1). These documents help inform child care staff of children’s health conditions so they may provide necessary health services.

Required Health Forms

1. Universal Health Certificate (5A DCMR § 152.1)

Q: Who completes the form?
A: Part 1 is completed by the child’s parent or guardian; Parts 2-4 are completed by the child’s licensed health care provider (e.g., a pediatrician, nurse practitioner or physician associate/assistant).

Q: When do I submit the form to the child development facility?
A: Submit these forms prior to the child’s first day of services and at least annually thereafter.

Q: Who collects the form?
A: Each child development facility has a process in place for collection. Contact your child’s facility if you are not sure how to submit!

2. Oral Health Assessment (for children age 3 and older) (5A DCMR § 152.1)

Q: Who completes this form?
A: Part 1 is completed by the child’s parent or guardian; Part 2 is completed by the child’s dental provider.

Q: When do I submit the form to the child development facility?
A: Submit these forms prior to the child’s first day of services and at least annually thereafter.

Who collects the form?
A: Each child development facility has a process in place for collection. Contact your child’s facility if you are not sure how to submit.

Additional Documentation for Special Circumstances

This list contains some of the most common documentation for special circumstances for children attending child care, but not all the documentation required for special circumstances. Check with your child care facility for any additional required documentation.

1. Emergency Medical Treatment Authorization Form (5A DCMR § 130j)

The Emergency Medical Treatment Authorization form is for emergency medical care, to be used only when the parent(s) or guardian(s) cannot be reached. This form should be updated and submitted to your child’s facility annually.

2. Medication Authorization Form(s) (5A DCMR §§ 153.1 - 153.13)

A child may require a Medication and Medical Procedure Treatment Plan depending on their health needs. This and other forms can be accessed at the DC Health School Health Services Program webpage. Please speak with your child’s primary care provider or your child’s facility if you have questions.

3. Food Allergy Plan (5A DCMR § 154.1)

A child’s parent(s), guardian(s), or licensed health care practitioner should provide the facility with a written care plan for each child with a food allergy. The plan should include instructions regarding the food the child is allergic to and the necessary steps that need to be taken to avoid that food, as well as a detailed treatment plan in the event of an allergic reaction. Plans should include names, doses and methods of administration of any medications that the child should receive in the event of a reaction. The plan should include specific symptoms that would indicate the need to administer one or more medications.

If your child has any dietary restrictions, please provide your child’s facility written instructions accompanied by written instructions from the child’s licensed health care provider.

4. Sleeping Positions (5A DCMR § 146.3)

If your child cannot sleep on their back and must sleep in another position, please submit written documentation from the child’s licensed health care professional to the facility.

5. Cloth Diapers (5A DCMR § 145.4)

If your child requires cloth diapers due to a special medical circumstance, please submit a written statement to the facility along with signed documentation from the child’s licensed health care professional.

More Resources