DLA Official Forms

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Form Number: DLA1855-1D, Part 3

Form Title: DLA CYP Diabetes Weekly Food and Carbohydrate Log

Form Version: Aug 2019

Status: Active

Functional Area: Installation Management

Opr: DM

Safeguards: PAS, OMB Collection

Electronic: Yes

Form Link: Documents/FormsSite/forms/DL1855-1D Part III.pdf

Type: Primary

Prescribed: DLAI 1015.02

Description: This form will be used as the log for tracking food and carbohydrates for children with Diabetes in a Child and Youth Program.

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: