Medium

Available on

Apple Android Windows

Daycare Emergency Transportation Mobile App

The Daycare Emergency Transportation mobile app provides a simple emergency preparedness contact form for child care providers. The form tracks not only tracks daycare emergency contacts, but is also used to log parent or guardian permission to transport children who are sick or injured in a child care emergency.

The daycare contact form app records information about the child's parent or guardian phone numbers, alternative emergency contacts, and whether permission to transport the child has been refused or granted.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Daycare Emergency Transportation Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Child's Name:

  • Ico date

    Date of Birth:

  • Ico textbox

    Father's (Guardian's) Name:

  • Ico textbox

    Mother's (Guardian's) Name:

  • Ico multiline

    Address:

  • Ico textbox

    Telephone:

  • Ico textbox

    Father/Guardian’s Employer:

  • Ico multiline

    Address:

  • Ico textbox

    Telephone:

  • Ico textbox

    Mother/Guardian’s Employer:

  • Ico multiline

    Address:

  • Ico textbox

    Telephone:

  • Ico statictext

    Please list 3 people to be contacted in an emergency in case I cannot reach either of you.

  • Ico textbox

    Relationship to child:

  • Ico multiline

    Address:

  • Ico textbox

    Telephone:

  • Ico textbox

    Alternate Contact:

  • Ico textbox

    Child's Physician (or name of clinic):

  • Ico multiline

    Address:

  • Ico textbox

    Telephone:

  • Ico textbox

    Child’s Dentist (or name of clinic):

  • Ico multiline

    Address:

  • Ico textbox

    Telephone:

  • Ico statictext

    Either Part One or Part Two need to be filled out.

  • Ico textbox

    This form only authorizes (provider name):

  • Ico statictext

    to secure emergency transportation for your child.

  • Ico textbox

    I give (name of provider)

  • Ico textbox

    my permission to transport my child (name of child)

  • ...and More!

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