Forms

Primary Forms 

The following four (4) forms must be filled out and submitted by the first day of school:

Emergency Contact Form

Health Inventory Form 

Lead Test Form

Required Immunizations 

Medication Authorization Forms

​Asthma Action Plan Form 

Required for all children who will store Asthma medication and/or inhalers at Little Earth, LLC

​

Emergency Action Plan - for Individuals with Allergy / Anaphylaxis 

Required for all children who will store an Epi-Pen or other allergy medications at Little Earth, LLC

​

Medication Authorization Form 

Required for all children who would like to have medicine (other than for asthma, allergy / anaphylaxis as listed above) administered at school including non-prescription medication.  Each medication must be listed on a separate form signed by the child's pediatrician. 

​

Parent Guide to Regulated Care

This is only required for new parents

Parent Guide to Regulated Care