Child Care Provider Forms

New Child Packet
Caretaker/Provider Agreement (JFS 01634)  
Emergency Transportation Authorization (JFS 01297)

Substitute Care Giver/New Household Member Packet
Conviction Statement (JFS 01329) (print, complete and mail to HCJFS Child Care)
Emergency Substitute Caregiver (JFS 01923)

Additional Forms

Authorization to Release Information to Hamilton County (HCJFS 0170-P)

Child Care Co-Payment Agreement (HCJFS 0139)

Daily Record for Infants & Toddlers (HCJFS 3257)

Delinquent Fees (HCJFS 4671)

Fire Drill Log (HCJFS 3037)

Illegal Firearm Notice (HCJFS 2999)

Incident/Injury Report (JFS 01299)

Liability Insurance Statement (JFS 01933)
Manual Claim for Attendance (JFS 01261)
Manual Claim for Attendance Instructions (JFS 01261 I)

Medical, Dental, and General Emergency Plan (JFS 01929)

No Smoking (HCJFS 0484)

Permission to Administer Medication (JFS 01644)

Permission to Transport Children on Routine Trips (HCJFS 3019)

Permission To Transport Children On Special Outings And Field Trips (HCJFS 3020)

Provider Medical Statement (JFS 01280)

Request for Child Abuse and Neglect Report Information (JFS 01302)

Request for Payment Adjustment (JFS 1292)
Request for Payment Adjustment Instructions (JFS 1292 I)

Sick Child Policy (HCJFS 3258)