Childcare Emergency Information Sheet
A childcare emergency information sheet — a child's key medical details (allergies, medications, conditions), doctor and hospital, insurance, parent and emergency contacts, authorized pickups, and consent to treat, kept where a caregiver can grab it fast.
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CHILD EMERGENCY INFORMATION Child: Sample Child DOB: 01/01/2018 Home: 123 Example St, Springfield ** IN A LIFE-THREATENING EMERGENCY, CALL 911 FIRST. ** ALLERGIES (and reactions) Peanuts (hives, swelling) — carries EpiPen. No known drug allergies. MEDICATIONS & DOSING Children's antihistamine as needed for mild reaction. EpiPen Jr. for severe reaction — call 911 after use. MEDICAL CONDITIONS / NOTES Mild asthma — inhaler in backpack. No other conditions. MEDICAL CONTACTS Pediatrician: Dr. Sample Pediatrics — (555) 010-1111 Hospital/ER: Springfield Children's Hospital — (555) 010-2222 Insurance: SampleCare — Policy 000-00-0000 PARENT / GUARDIAN CONTACTS 1) Sample Parent — (555) 010-3333 2) Second Parent — (555) 010-4444 Other emergency contact: Aunt Sample (aunt) — (555) 010-5555 AUTHORIZED FOR PICKUP Sample Parent, Second Parent, Aunt Sample (photo ID required) CONSENT TO TREAT In an emergency where a parent/guardian cannot be reached immediately, I authorize the caregiver to seek and consent to emergency medical treatment for my child, and to share this information with emergency responders and medical staff. _____________________________ Date: __________ Parent / guardian signature
About this template
A childcare emergency information sheet puts the few facts that matter in a crisis on one page a babysitter, nanny, grandparent, or daycare can grab in seconds — because in an emergency no one wants to be searching a phone for a pediatrician's number. Lead with the **life-threatening reminder to call 911 first**, then the highest-stakes medical facts: **allergies and the exact reaction** (and where any EpiPen or rescue med is kept), **current medications with dosing**, and any **conditions** like asthma. Follow with the **medical contacts** a caregiver or paramedic will need — pediatrician, preferred hospital/ER, and insurance details — and then **how to reach the parents**, plus at least one **backup emergency contact** in case the parents are unreachable. Two often-overlooked sections make the sheet genuinely useful: a list of **who is authorized to pick the child up** (childcare providers should release a child only to named, ID-verified adults), and a **consent-to-treat statement** signed by a parent, which lets a caregiver authorize emergency treatment when a parent cannot be reached fast — many providers and ERs want this in writing. Keep it **current** (re-check it each season and whenever meds or contacts change), make sure the caregiver actually knows **where it lives** (fridge, diaper bag, the sitter's hand), and remember it holds **sensitive health information** — share it only with the people who care for the child and store it accordingly. This is a practical caregiver aid, not a legal or medical document; for anything beyond first aid, the instruction is always the same: call 911 and then the parents.
When to use it
- Leaving a child with a babysitter, nanny, or relative.
- Enrolling at a daycare or starting a new childcare arrangement.
- Trips, camps, or activities where a non-parent supervises the child.
- Keeping a quick-grab medical reference on the fridge or in a bag.
What to include
- Child name, DOB, and home address.
- Allergies/reactions, medications and dosing, and conditions.
- Pediatrician, preferred hospital/ER, and insurance.
- Parent/guardian contacts plus a backup emergency contact.
- Authorized pickups and a signed consent-to-treat statement.