Welcome to our UHMCC ‘Ohana!
These are the forms included in our Enrollment Packet for families that have been offered a space in our program. Please read, fill out, sign and return the required forms. Please include any necessary supplementary documentation. We are excited to have you!
Important Documents to Read
Forms that need to be read, filled out and returned
| Income Disclosure Form | This is a required form is specific to this fiscal year. All families must complete this form, including new families who just completed it for the Summer or Fall start. If you do not wish to disclose your income, you may indicate “Above Scale” as your income, and you will fall into our Step 5 for childcare rates. This form must be updated annually and if/when there is a change in income or household size |
| Identification and Contact Card | Please complete the ID card. You must indicate at least 2 adults (other than the child’s parents) as authorized pick up/emergency contacts. Emergency contacts must be on the island of O‘ahu. Please make sure the information is complete and up to date. |
| Family History Form | The information we ask for on this form enables us to better understand your child and provide the best care possible. The form also allows you to express your parental beliefs about your child’s care and to share anything else you’d like us to know about your child’s comfort and habits. |
| The following forms must be returned to UHMCC by the time your child begins receiving care | |
| Health Entrance Requirements (includes Form 14) | We ask that you provide three verifications: Tuberculosis clearance; Immunization record; and Physical examination. The Department of Education Student’s Health Record (also referred to as Form 14) and the Pre-K Health Record supplement must be completed by your physician and meet the State of Hawaii School Entrance requirements. |
| Permission Form | Please review and sign |
| Parent Handbook Agreement | Located at the very end of the Family Handbook. Please have both parents sign and turn in the last page of the handbook verifying that you’ve read and agree to the term and procedures identified. |
| UH Status Verification | This sheet details how to provide us with verification of your UH affiliation, whether you are a student, faculty, or staff member. |
If any of the circumstances below apply to your child, please fill out the appropriate forms below.
Supplementary Medical Forms↗
Forms required your child has medical needs (must be updated every Fall semester).
Non-Medical Needs ↗
If your child has food preferences (non-medical), you must fill out a form. This must also be updated every Fall semester.
Other Forms ↗
Additional forms as needed (Occasional Pick-up, Request for schedule change, CCAMPIS Grant information).