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Child Information Update
1
2
3
Parent/ Guardian Name
(Required)
First Name
Last Name
Mobile Phone
(Required)
Email
(Required)
Child Information
YOU MUST FILL OUT EACH SECTION FOR EACH CHILD WITH DETAILED AND THE MOST CURRENT INFORMATION. DO NOT JUST SAY "AS PREVIOUS" OR "SAME AS BEFORE".
Child 1
Child 1 Name
(Required)
First
Last
Gender
(Required)
- select an option -
Male
Female
Other
Date of Birth
(Required)
DD slash MM slash YYYY
PLEASE INCLUDE AS MUCH DETAIL AS POSSIBLE
Educators are provided this information to assist them with their Education and Planning.
Describe any Allergies AND management methods
Describe any Dietary Restrictions AND management methods
Describe any Behaviour Alerts AND management methods
Describe any Disabilities AND support required
Describe any Medical Conditions AND list medications, administration schedule, dosages etc.
Is Medication Prompt Required?
(Required)
Yes
No
Is Medication Assistance Required?
(Required)
Yes
No
Is Medication Administration Required?
(Required)
Yes
No
Describe Developmental Status (e.g. breast, bottle, eating solids, crawling, walking, sleeping/eating patterns)
Describe Hobbies, Interests, Likes, Dislikes, Personality Traits
Child 2
Child 2 Name
First
Last
Gender
- select an option -
Male
Female
Other
Date of Birth
DD slash MM slash YYYY
PLEASE INCLUDE AS MUCH DETAIL AS POSSIBLE
Educators are provided this information to assist them with their Education and Planning.
Describe any Allergies AND management methods
Describe any Dietary Restrictions AND management methods
Describe any Behaviour Alerts AND management methods
Describe any Disabilities AND support required
Describe any Medical Conditions AND list medications, administration schedule, dosages etc.
Is Medication Prompt Required?
Yes
No
Is Medication Assistance Required?
Yes
No
Is Medication Administration Required?
Yes
No
Describe Developmental Status (e.g. breast, bottle, eating solids, crawling, walking, sleeping/eating patterns)
Describe Hobbies, Interests, Likes, Dislikes, Personality Traits
Child 3
Child 3 Name
First
Last
Gender
- select an option -
Male
Female
Other
Date of Birth
DD slash MM slash YYYY
PLEASE INCLUDE AS MUCH DETAIL AS POSSIBLE
Educators are provided this information to assist them with their Education and Planning.
Describe any Allergies AND management methods
Describe any Dietary Restrictions AND management methods
Describe any Behaviour Alerts AND management methods
Describe any Disabilities AND support required
Describe any Medical Conditions AND list medications, administration schedule, dosages etc.
Is Medication Prompt Required?
Yes
No
Is Medication Assistance Required?
Yes
No
Is Medication Administration Required?
Yes
No
Describe Developmental Status (e.g. breast, bottle, eating solids, crawling, walking, sleeping/eating patterns)
Describe Hobbies, Interests, Likes, Dislikes, Personality Traits
Child 4
Child 4 Name
First
Last
Gender
- select an option -
Male
Female
Other
Date of Birth
DD slash MM slash YYYY
PLEASE INCLUDE AS MUCH DETAIL AS POSSIBLE
Educators are provided this information to assist them with their Education and Planning.
Describe any Allergies AND management methods
Describe any Dietary Restrictions AND management methods
Describe any Behaviour Alerts AND management methods
Describe any Disabilities AND support required
Describe any Medical Conditions AND list medications, administration schedule, dosages etc.
Is Medication Prompt Required?
Yes
No
Is Medication Assistance Required?
Yes
No
Is Medication Administration Required?
Yes
No
Describe Developmental Status (e.g. breast, bottle, eating solids, crawling, walking, sleeping/eating patterns)
Describe Hobbies, Interests, Likes, Dislikes, Personality Traits
Child 5
Child 5 Name
First
Last
Gender
- select an option -
Male
Female
Other
Date of Birth
DD slash MM slash YYYY
PLEASE INCLUDE AS MUCH DETAIL AS POSSIBLE
Educators are provided this information to assist them with their Education and Planning.
Describe any Allergies AND management methods
Describe any Dietary Restrictions AND management methods
Describe any Behaviour Alerts AND management methods
Describe any Disabilities AND support required
Describe any Medical Conditions AND list medications, administration schedule, dosages etc.
Is Medication Prompt Required?
Yes
No
Is Medication Assistance Required?
Yes
No
Is Medication Administration Required?
Yes
No
Describe Developmental Status (e.g. breast, bottle, eating solids, crawling, walking, sleeping/eating patterns)
Describe Hobbies, Interests, Likes, Dislikes, Personality Traits
Child 6
Child 6 Name
First
Last
Gender
- select an option -
Male
Female
Other
Date of Birth
DD slash MM slash YYYY
PLEASE INCLUDE AS MUCH DETAIL AS POSSIBLE
Educators are provided this information to assist them with their Education and Planning.
Describe any Allergies AND management methods
Describe any Dietary Restrictions AND management methods
Describe any Behaviour Alerts AND management methods
Describe any Disabilities AND support required
Describe any Medical Conditions AND list medications, administration schedule, dosages etc.
Is Medication Prompt Required?
Yes
No
Is Medication Assistance Required?
Yes
No
Is Medication Administration Required?
Yes
No
Describe Developmental Status (e.g. breast, bottle, eating solids, crawling, walking, sleeping/eating patterns)
Describe Hobbies, Interests, Likes, Dislikes, Personality Traits
Child 7
Child 7 Name
First
Last
Gender
- select an option -
Male
Female
Other
Date of Birth
DD slash MM slash YYYY
PLEASE INCLUDE AS MUCH DETAIL AS POSSIBLE
Educators are provided this information to assist them with their Education and Planning.
Describe any Allergies AND management methods
Describe any Dietary Restrictions AND management methods
Describe any Behaviour Alerts AND management methods
Describe any Disabilities AND support required
Describe any Medical Conditions AND list medications, administration schedule, dosages etc.
Is Medication Prompt Required?
Yes
No
Is Medication Assistance Required?
Yes
No
Is Medication Administration Required?
Yes
No
Describe Developmental Status (e.g. breast, bottle, eating solids, crawling, walking, sleeping/eating patterns)
Describe Hobbies, Interests, Likes, Dislikes, Personality Traits
Confirmation
Confirmation
(Required)
Yes
Confirmation I confirm that all information completed within this form is true and accurate. I also agree to allow ALHCA to share my information with Educators, the In Home Care Support Agency, the Department of Education, the Department of Human Services, Child Care Subsidy Help Desk and Software Providers, fellow Service Providers, ACCS referral organisations and other authorised personnel. I also give authorisation for my Educator to seek medical treatment for my child by a registered medical practitioner, hospital or ambulance service and if required, transport the child to hospital.
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