Iowa Child Care Provider Physical Examination Report 2026

1. Click ‘Get Form’ to open the Child Care Provider Physical Examination Report in the editor.
2. Begin by entering your name and the date of the exam in the designated fields at the top of the form.
3. In the Immunization Status section, consult with your physician and check the appropriate box regarding your immunization history.
4. Complete the Tuberculosis Screening section by assessing for symptoms and risk factors. Ensure that your physician checks and dates this section as required.
5. Fill out the Overall Health Status questions, indicating any known communicable diseases or conditions that may affect child care responsibilities.
6. Conclude by selecting one of the options regarding your involvement in child care and providing any necessary accommodations or restrictions.
7. Finally, have your health care provider sign and provide their details at the bottom of the form.

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