Form LIC 9222. Blood Glucose Testing Consent/Verification Child Care Facilities - California

Form LIC 9222 is used in California by child care facilities to obtain consent and verification for blood glucose testing for children with diabetes. This form is completed by parents or guardians to authorize the facility staff to perform blood glucose testing on their child.

The form consists of sections that require information about the child, details about diabetes management, and parental consent. Important fields include the child's name, diagnosis of diabetes, instructions for testing and treatment, any potential risks or allergies, and the parent or guardian's signature to indicate their consent. It is crucial to accurately document all necessary information, ensure proper authorization, and follow appropriate procedures for blood glucose testing within child care facilities.

An application example of this form would involve a child care facility providing Form LIC 9222 to parents or guardians when a child with diabetes is enrolled. The parent or guardian would complete the form by providing the child's information, details about diabetes management, and their consent through signature. By obtaining proper consent and following established protocols, child care facilities can support the health and well-being of children with diabetes under their care.