Free Daycare Form

Child Illness Notice

Document symptoms observed while a child is in care, parent notification, and pickup information. Information entered here is not saved to CubbyTrack.

Illness exclusion and return-to-care requirements vary by state, local health department, and childcare licensing rules. Follow your program's applicable requirements.

Child Illness Notice

Childcare Health Documentation

Child Information

Symptoms Observed

Care Provided

Parent / Guardian Notification

Pickup / Departure

Additional Notes

Staff Signature / Date

Parent / Guardian Signature / Date

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