Intake Form for Children Under 2 Years - Wisconsin DCF
This intake form is used by the Department of Children and Families in Wisconsin to gather information about children under 2 years of age. It aids child care workers in individualizing care programs. It is mandatory for certified providers and voluntary for licensed family and group child care centers.
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How do I fill this out?
To fill out this form, you will need to complete sections detailing your child's personal information, health, meals, sleep, and diapering/toileting routines. Ensure all relevant information is provided and updated regularly. The completed form must be on file at the childcare center before your child's first day of attendance.

How to fill out the Intake Form for Children Under 2 Years - Wisconsin DCF?
1
Complete sections with your child's personal information.
2
Provide details about your child's health conditions.
3
Fill out the current feeding schedule and dietary preferences.
4
Describe sleep habits and routines.
5
Provide information about diapering and toileting routines.
Who needs the Intake Form for Children Under 2 Years - Wisconsin DCF?
1
Child care providers - To gather important information about children under 2 years.
2
Parents - To provide necessary details about their child's routines and health.
3
Certified child care centers - Compliance with state regulations.
4
Licensed family and group child care centers - To meet care requirements.
5
Health professionals - To understand the child's health conditions and needs.
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Make any changes or updates as needed.
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Save the updated version of the document.
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Download and submit the completed form.

What are the instructions for submitting this form?
Submit the completed form to the child care center where your child will be attending. Ensure it is filed before the first day of attendance. Emails, fax numbers, and physical addresses for submission should be provided by the child care center. My advice is to keep a copy of the completed form for your records.
What are the important dates for this form in 2024 and 2025?
Ensure the form is on file at the child care center before your child's first day of attendance for both 2024 and 2025.

What is the purpose of this form?
The purpose of this intake form is to gather detailed information about children under 2 years of age to aid in providing individualized care at child care centers. The form collects data on personal information, health conditions, dietary needs, sleep habits, and diapering/toileting routines. By having this information, child care workers can ensure they meet the specific needs of each child, promoting their well-being and development.

Tell me about this form and its components and fields line-by-line.

- 1. First Day of Attendance: The initial date when the child starts attending the care center.
- 2. PARENT / CHILD NAME AND ADDRESS: Includes the names and address of the child and parents, along with contact details.
- 3. HEALTH: Records any health conditions that might affect the child's care.
- 4. MEALS: Details the child's feeding schedule, food types, allergies, and any special feeding problems.
- 5. SLEEP: Provides information on the child's sleep schedule, sleep position, and related habits.
- 6. DIAPERING / TOILETING: Covers diapering routines, toilet training status, and any toileting problems.
What happens if I fail to submit this form?
Failure to submit this form may result in noncompliance with state regulations.
- Issuance of Noncompliance Statement: The childcare center may receive a noncompliance statement affecting their certification.
- Incomplete Child Information: Lack of proper information to personalize care for the child.
- Regulatory Issues: Potential regulatory issues for certified childcare providers.
How do I know when to use this form?

- 1. Initial Enrollment: Use this form during the initial enrollment of a child in the care center.
- 2. Update Child Information: Regularly update the form with any changes in the child's health or routines.
- 3. Compliance: Certified providers must use this form to comply with state regulations.
- 4. Individualized Care: Ensure individualized care based on the child's specific needs and routines.
Frequently Asked Questions
Can I edit the intake form on PrintFriendly?
Yes, you can easily edit the intake form using PrintFriendly’s PDF editor.
How do I fill out the child care intake form?
Complete all sections with your child's information, health details, feeding schedule, sleep routines, and diapering/toileting habits.
Who needs to use this form?
This form is needed by child care providers, parents, certified child care centers, licensed family and group child care centers, and health professionals.
How do I sign the form on PrintFriendly?
Use PrintFriendly’s signing tool to add your digital signature directly to the form.
How can I share the completed form?
Use PrintFriendly’s sharing options to send the form via email or generate a shareable link.
Is the completion of this form mandatory?
It is mandatory for certified providers in Wisconsin and voluntary for licensed family and group child care centers.
Where should the completed form be kept?
The completed form should be kept in the room where care is provided.
How do I update the form?
Regular updates can be noted on the form or on an attached separate sheet.
What should I do if I need more space to fill out the form?
Attach a separate sheet if more space is needed.
Can I download the completed form?
Yes, after editing and saving the form on PrintFriendly, you can download it for submission.
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