I'm a Seattle parent on the brink of a career change.
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Tuesday, April 6, 2010

Caregiver Brochure

Image from beaglepaws.com

Here’s the situation: my in-laws live in a small town near the Canadian border. Sometimes my husband and I leave our young children with their grandparents while we buzz around. Everyone has a great time and there are almost never any problems. Of course, sometimes there are problems, and we were recently unprepared.

There are limited medical services in this small town. The nearest ER is across the border, in Canada. On one recent visit, while we were away, one of the kids did a faceplant into the floor and needed her lip stitched. Luckily we hadn't gotten very far, but we had no idea where to take here for care. Not only do we have to do this research whenever we travel in the future (no more lazy parents!), we need to provide a lot more information to the caregivers, in case we aren't able to return to the kids quickly. This time we were just across the border on our way to the Vancouver Olympics, but next time we could be flying to Europe or cruising South America! (Hey, it could happen.)

Here’s a link to the easy form I created to hand over to the grandparents along with the kids' overnight bags. The form is meant to be printed on a single page, front & back, and folded in half into a brochure. I included everything my super-organized parent friends could think of. Most people will find this overdone, but it's just a Word Doc and can easily be pared down as needed. If you feel moved to make your own form, this list of the elements in my brochure might be handy:

1. Medical Release to allow caregivers to make medical decisions in my absence
2. Recent photo, height, weight
3. Allergies
4. Immunizations
5. Consent to transport over borders
6. Photocopy of Nexus card
7. Photocopy of passport
8. Location and hours of nearest walk-in-clinic
9. Location of nearest emergency room
10. Contact information for parents
11. Contact information for children’s pediatrician and dentist

I hope this information will help your family too. Update the information at least once a year. I’m going to review it on the kids birthdays as an easy way to remember.

If you have ideas for improvement, please leave a comment!

Good health to all,


  1. Excellent info Jenny. You may want to check and see if the photocopies of Nexus and Passport need to be notorized to make them valid for use.

    Love the Blog.

    Karen B

  2. Great point, Karen! The US Customs & Border Protection site specifies that the travel permission letters be notarized. See page 6 of their Know Before You Go (very long) document: http://bit.ly/8YzWhY.

    I found many, many different varieties of "Permission to treat a Minor" forms. Google this term to see what applies in your state; notarization may not be necessary.