Missouri Ozarks Community Action, Inc
Head Start
Center Health Concerns Report
Child's Name:
Center:
Select
Belle
Camdenton
Crawford Co
Dixon
Eldon
Iberia
Lebanon
Linn Creek
Osage
Rolla
Gasconade Co
St James
Waynesville
Tri-County
Occurance Date:
What is the Health Concern?
Head Lice
Skin Rash
Fever
Bodily Fluid Exposure
Other Health Concerns
Were Parents Notified?
Yes
No
Was Child Picked-up?
Yes
No
Comments:
Report submitted by:
E-mail:
The form you are about to submit will be sent to the Director of Health Services. You will receive a receipt by return email.
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