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Medical Forms

To complete your child's enrollment with us, we need:

  • A yearly Early Childhood Health Assessment

  • An up-to-date Record of Immunizations

Health Assessment and Immunization Record

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Part I of the Assessment is to be completed by the parent/guardian.

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Part II is to be signed and dated by a physician. We will also accept a physician-generated Health Form as Part II.

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Please download & complete the form.

(Opens as a PDF) 

Diaper Cream

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If you'd like to have diaper cream applied to your child while at the center, you must complete and submit the form below.

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Click on and fill out the diaper cream form

(Opens in a separate, secure website - PdfFiller.com) ​

Sunscreen & Tick Repellent

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If you'd like to have sunscreen/tick repellent applied to you child while at the center, you must complete and submit the form below.

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Tick repellent is made at the school and is non-chemical based. You can pick up a listed ingredients sheet in the office.

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Click on and fill out the consent form

(Opens in a separate, secure website - PdfFiller.com) ​

Emergency Health Care Plan

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If your child has a medical condition requiring emergency medication, we require an emergency health care plan from your physician.

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Please download & complete the form.

(Opens as a PDF) 

Authorization to Administer Medication

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Emergency medications must be provided in their original container along with the Authorization to Administer Medication Form.

 

Please note that a separate form is required for each type of medication.

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Please download & complete the form.

(Opens as a PDF) 

United Methodist Child Care Center

Address:

10 Chapman Ln, Gales Ferry, CT 06335

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Phone: 

(860) 464-7482

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Hours of Operation:

Monday thru Friday - 7:00 AM - 5:30 PM

Copyright © 2026 United Methodist Child Care Center (Est. 1972)

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