Health Information Form--CNICCYP 1700/52

Families use this form when they are enrolling and registering their child to let the program know of any identified needs their child may have, including food or other allergies, medication needs, food intolerances and dietary needs, and any early intervention or special education needs. Parents are encouraged to complete the form electronically and then email the completed form to their CYP. A separate form must be completed for each child the family is enrolling in the CYP.