Applications and Assorted Forms

Welcome to Causey's!

If you have any questions or would like help, please give us a call.  We'd be happy to set an appointment with you to help complete your forms.

Se habla español.


If your child is currently enrolled at Causey's, please remember that it is important that we have complete, up-to-date forms on file for all children enrolled in our programs.

Special Health Forms

If your child has allergies, asthma, and/or a need for medicaition to be administered by our staff, please use the below forms and packets.

● These are for children enrolled in any of our programs.

Allergy Plan Forms Packet
If your child has any allergies or food intolerances, we are required to have this packet on file. It includes an emergency plan for allergic reactions and authorization for allergy medications.
Adobe Acrobat document [2.0 MB]
Asthma Plan Forms Packet
If your child has asthma, we are required to have these forms on file. They let us know more about your child's particular case and how to prevent and treat attacks.
Asthma Packet 2011.pdf
Adobe Acrobat document [875.2 KB]
Medication Authorization Form
If your child has medication, which you need us to administer during care, please fill out this form. It will accompany your child's medication and help keep track of dosage information.
Medication Authorization Form.pdf
Adobe Acrobat document [129.4 KB]
Seizure Health & Emergency Plan
If your child has a seizure disorder or a history of seizures, you will need to fill out this form. It contains an individualized health plan and an emergency plan.
Seizure Health Emergency Plan.pdf
Adobe Acrobat document [197.9 KB]