First United Methodist Preschool

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Medical Forms

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Statement of Child Health: Each child that attends must have a statement of health with a physician’s signature on the form. The physician must attest that the child is in good health and able to participate in the program.  The statement is good for one year. The preschool office will contact you when your child’s physician’s signature expires. **Please note: your physician may use our form (provided below) or a form of their choice.  FUMP will accept any medical form signed by your physician stating that your child can participate.

STATEMENT OF CHILD HEALTH FORM

Vaccination Records:  The record must include your child’s name, date of birth, your physician’s name/clinic name, and the name/date/dose of each vaccination received. The immunization record MUST have a signature; a handwritten or a rubber stamp is acceptable.

Food Allergies: All children with a diagnosed food allergy must have a written food allergy plan on file with the preschool office. This form MUST be signed by your child’s physician or allergist.  If you have any further questions, please contact the preschool office. FOOD ALLERGY PLAN FORM

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Contact Us

First United Methodist Preschool
1201 Lavaca St. | Austin, TX 78701
(512) 478-5709
preschool@fumcaustin.org

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1201 Lavaca Street, Austin, Texas 78701· Ph. (512) 478-5709, Fax. (512) 478-9365 | Log in