Childcare Health Records & Immunization Requirements 2026

Before your child can start daycare, you'll need to navigate health requirements. From immunization records to medical forms, childcare facilities require documentation to ensure all children's safety. Understanding these requirements helps you prepare for enrollment and avoid delays.

This guide explains the health documentation you'll need for childcare.

Child health records

Overview of Health Requirements

Why Health Documentation Matters

Protection for all:

Prevents disease outbreaks
Protects immunocompromised children
Ensures emergency preparedness
Documents special health needs
Required by state licensing

Common Required Documents

Most centers require:

Immunization records
Physical examination form
Emergency medical authorization
Allergy and medical conditions information
Health history form

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Immunization Requirements

Standard Childhood Vaccines

Typically required for childcare:

DTaP (diphtheria, tetanus, pertussis)
Polio (IPV)
MMR (measles, mumps, rubella)
Hib (Haemophilus influenzae type b)
Hepatitis B
Varicella (chickenpox)
Pneumococcal (PCV)
Rotavirus (may vary)

Schedule Matters

Requirements based on age:

Vaccines given at specific ages
Multiple doses needed for full protection
Must be on schedule for age
"Catch-up" possible if behind

Where to Get Records

Obtain documentation from:

Pediatrician's office
State immunization registry
Previous healthcare providers
Birth hospital (for initial vaccines)

Keeping Records Updated

Stay current:

New vaccines needed as child ages
Boosters required
Update daycare when vaccines given
Keep copies at home

Immunizations

Physical Examination Forms

What's Required

Typical requirements:

Recent physical (within 6-12 months)
Completed by licensed physician
Confirms child healthy for childcare
May need renewal annually

What's Included

Form typically covers:

Height, weight, vital signs
Developmental assessment
Vision and hearing screening
Chronic conditions noted
Medications listed
Provider signature and date

Scheduling the Physical

Plan ahead:

Book well before enrollment date
Request form from daycare first
Bring form to appointment
Ask for copies

Special Health Considerations

If your child has:

Chronic conditions (asthma, diabetes)
Allergies
Developmental concerns
Physical limitations
Ongoing treatments

You'll need:

Condition documented
Action plan if applicable
Medication authorization
Staff training arrangements

Allergy Documentation

Food Allergies

Required documentation:

Specific allergens listed
Symptoms of reaction
Treatment protocol
Physician signature
Emergency contact

Action plans:

Step-by-step response
Medication administration
When to call 911
Posted in classroom
Staff trained

Medication Authorization

If emergency medication needed:

Epinephrine (EpiPen)
Prescription required
Authorization form signed
Medication properly labeled
Staff training on use

Non-Food Allergies

Also document:

Environmental allergies
Insect sting allergies
Medication allergies
Latex allergies
Prevention measures

Medical Conditions and Care Plans

Chronic Conditions

Common conditions requiring plans:

Asthma
Diabetes
Severe allergies
Seizure disorders
Heart conditions
Bleeding disorders

Care Plan Components

Include:

Condition description
Daily management needs
Emergency procedures
Medication schedules
Activity restrictions
Emergency contacts

Medication at Daycare

If child needs medication:

Prescription label required
Written authorization from doctor
Parent signature
Specific dosage instructions
Storage requirements

Medical planning

Emergency Authorization Forms

Medical Treatment Authorization

Allows daycare to:

Seek emergency treatment
Transport to hospital
Make immediate care decisions
Work with emergency responders

Includes:

Preferred hospital
Insurance information
Emergency contacts
Primary physician
Known conditions/allergies

Emergency Contact Information

Provide:

Multiple contacts
Phone numbers (work, cell, home)
Relationship to child
Authorization levels
Alternate pickup persons

State-Specific Requirements

Variations by State

Requirements differ:

Which vaccines required
Exemption policies
Physical exam timing
Required forms
Additional screenings

Finding Your State's Requirements

Check:

State health department website
State childcare licensing website
Your childcare provider
Pediatrician's office

Exemptions

Types may include:

Medical exemptions (all states)
Religious exemptions (most states)
Philosophical exemptions (some states)

Note: Exemption policies have been changing; check current requirements.

Ongoing Health Requirements

Annual Updates

Yearly requirements may include:

Updated immunizations
Annual physical
Renewed authorizations
Updated emergency contacts
Current insurance information

When to Update Records

Update when:

New vaccines received
Health conditions change
New allergies identified
Medications change
Contact information changes

Keeping Good Records

Organize:

Keep copies of everything
Digital backup
Know expiration dates
Track vaccine schedules
Calendar renewal dates

Common Questions

"What If Vaccines Are Delayed?"

Options:

May be able to start on catch-up schedule
Some daycares may defer enrollment
Medical exemption if doctor recommends delay
Work with pediatrician on timeline

"What If I Can't Find Records?"

Solutions:

Contact state immunization registry
Request from all previous providers
May need to revaccinate if no records
Start fresh if necessary

"Do All Daycares Have Same Requirements?"

Variations exist:

State minimums apply to all
Individual centers may require more
Religious programs may differ
Check specific facility

"What About Sick Child Policies?"

Separate from enrollment:

Covered in illness policies
When child must stay home
When child can return
Documentation for return

Preparing Your Documentation

Before Enrollment

Gather:

Immunization records
Schedule physical exam
Complete health history form
List all allergies and conditions
Gather medication authorizations

Checklist for Enrollment

Documents to have ready:

[ ] Immunization record
[ ] Physical exam form
[ ] Health history
[ ] Allergy documentation
[ ] Emergency authorization
[ ] Insurance card copy
[ ] Medication forms (if applicable)
[ ] Care plans (if applicable)

Working with Your Pediatrician

Request:

Complete forms at appointment
Copies for your records
Vaccination schedule
Health clearance letter if needed
Care plans for conditions

Key Takeaways

Know requirements:

Check state and center requirements
Get forms early
Allow time for appointments
Plan for processing