DLA Official Forms

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Form Number: DLA1849-4
Form Title: DLA CYP Child Illness/Injury Readmission Record
Form Version: Aug 2019
Status: Active
Functional Area: Installation Management
Opr: DM
Safeguards: PAS, PII, OMB Collections
Electronic: Yes
Form Link: Documents/FormsSite/forms/DL1849-4.pdf
Type: Primary
Prescribed: DLAI 1015.02
Description: This form will be used to dismiss children from a Child and Youth Program due to potential illness or communicable disease, as well as to readmit children cleared by a physician when applicable.
Records Retention: 7304.1 Child Development Center. Temporary. Cutoff at end of Event. Maintain records as long as a child is enrolled. Upon termination from the program, forward records to Child Development Services Coordinator.
Form Audience: