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Indiana state form 49969

Indiana form 49969 care 2025

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The document is a health care program form for child care centers, specifically the Child Care Center Health Record. It includes sections for recording a child's medical history, physical examination details, immunization records, and any health conditions that may affect participation in group activities. The form requires signatures from health care providers and must be updated annually.

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Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (80 Votes)
2011	4.5 Satisfied (63 Votes)

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What is a dependent care verification form?

This form is to be completed by your provider after dependent care expenses have been incurred and should be used in place of dependent care documentation. Attach this form to an online or debit card claim via your online account or to a Claim Form.

How many kids can you watch in Indiana without a license?

To become a CCDF certified unlicensed provider: Child care providers must meet the CCDF provider eligibility standards. Submit your application online at I-LEAD via Open a New Program on the Dashboard. Pass onsite inspection from the Legally licensed exempt provider consultant.

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