LCP
Legally Certified Provider
Application Packet
These forms are all included in the Legally Certified Provider Application Packet.
- Full Packet
- LCP Cover Sheet
- What is an LCP?
- Dane's Law
- LCP Application
- LCP Family Association Form and Health & Safety Checklist
- W-9
- LCP Release of Information
- FBI Disclosure Form
- LCP Statement of Health Form
- Medication Administration Attestation
- Medication Authorization Form
- Over the Counter Medication Authorization Form
- Immunization Certification
- Attendance Sign-in/Sign-out
- Medication Administration Log
- Medication Error/Incident Report
