Personal Needs Form

Child Details
Health/Disability
Allergies
Mobility
Personal Care
Medication

Medication to be taken at the Play Centre and given by PACE staff (Including any emergency medication for conditions such as asthma, epilepsy and anaphylaxis)

Medication (given at home)

Please note that parents are responsible for providing up to date and correct information regarding dosage and administration of medication. Any medication given at the playcentre must be received in original packaging with pharmacist label, clearly stating child’s name, dosage and expiry date.

Please see the play procedures guide (available at the playcentre) for more information.
I authorise PACE staff to give my child the medication as detailed above

Eating/Drinking
Communication
Behaviour
Cultural Practice
Other personal/additional needs