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CPR & First Aid Classes
Medication Administration Classes
Medical-Physical Statements
Nurse Delegation Request
- Self Schedule A Nurse Delegation
- Upload the child's health care plan
Online Standard Precautions
- Book Standard Precautions Course
Discounts & Invoice Requests
- Bulk Purchase Discounts
- Invoice Request
Child Care Health Consultants
Documents & Resources
Help - FAQ
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Virtual Medical Physical Appointments

Fill out your medical history form and schedule your precautionary phone appointment.
If you report a concerning medical condition, you can expect a phone call.
No phone call is needed if you have no relevant medical conditions.
Your medical physical statement will be emailed to you.

Medical History Form

First name*

Last name*

Email*

Phone*

School Name*

Do you have any medical or psychological conditions that could interfere with your ability to safely work with children? *

Yes

Do you have any of the following medical conditions? Check all that apply.*

None

Low blood sugar

Fainting or dizzy spells

Seizures

Strokes

Moderate to severe back problems

Weakness or numbness in your arms or legs

History of Tuberculosis

Draining wounds/sores

Communicable skin rash

Currently, are you following medically advised or prescribed work restrictions? *

Yes

Currently, is your employer making modifications to your job duties to meet your medical needs?*

Yes

To the best of your knowledge, did you receive all of your childhood immunizations?*

Yes

Other

Do you agree to immediately contact your doctor for any new changes to your physical or mental health that could interfere with you safely working with children? *

Yes

I agree to the release of liability listed on coloradocprpros.com website.*

Yes

Terms & Conditions

Disclaimer

Refunds

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