Forms

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

Provider Forms

  1. Admission and Arrangement Form 9-2019 (PDF)
  2. Alcohol Drug Use Policy fillable form (PDF)
  3. Allergy Information Form 7-2017 (PDF)
  4. Background Study Documentation Form (PDF)
  5. Checklist for Children's Records (PDF)
  6. COVID-19-preparedness-plan-optional-template 6-19-20
  7. Crib Safety Inspection form 06 2014 (PDF)
  8. Daily Attendance Record 8 2015 (PDF)
  9. Emergency Preparedness Plan
  10. Enrollment Form (PDF)
  11. Enrollment Form Interactive Version 2014 (PDF)
  12. Fire and Storm Drill Log and Floor Plan with Sample (PDF)
  13. Freedom to Breathe Sample 6 17 2014 (PDF)
  14. General Training Record (PDF)
  15. Grievance Policy fillable form (PDF)
  16. Immunization Record MDH 2019.pdf
  17. Liability Insurance Notice to Parents Guardians 8 2018 (PDF)
  18. License Capacity Breakdown (PDF)
  19. Maltreatment of Minors Mandated Reporting
  20. Data Privacy-Tennessen Notice
  21. Infant Rolling over Parent Statement for Infant Less Than Six Months Old
  22. Parental Consent (Swaddling) 6 2018 (PDF)
  23. Permission to Administer Non-Prescription and Prescription Meds (PDF)
  24. Permission to Take Child on Field Trips (PDF)
  25. Photo Release
  26. Physicians Directive for Alternative Infant Sleep Position (PDF)
  27. Reduced Fee Form 2021(PDF)
  28. Rule and Statute Summary Family Child Care DHS-7747-ENG 10-20
  29. Sample Policy (PDF)
  30. Serious Injury Reporting Form DHS-7774-ENG 3-20
  31. Substitute Tracking Log
  32. Swimming Pool Permission
  33. Training Record 2020 Licenseholder Co-Applicant 2nd Adult
  34. Trampoline Permission (PDF)
  35. Travel and Activity Authorization
  36. Variance Forms Combined DHS-7297 (open with Internet Explorer)
  37. Variance Forms Combined (non-fillable) 7297-ENG
  38. Wading Pool Permission (PDF)