Forms

Name	Description
2025-2026 IPCDC Calendar	View the dates that the IPCDC is open/closed
2024-2025 IPCDC Calendar	View the dates that the IPCDC is open/closed
Child Care Rates / How To Pay Your Bill	View childcare rates and instructions on how to pay your bill.
Identification & Emergency Information Changes	Make changes to address, phone number, or people authorized to pick-up/drop-off your child.
Schedule Adjustment Request	Make changes to your child's current childcare schedule. $20 fee may apply.
Enrollment Status Change Form	Use this form to request an extended absence due to illness/injury, withdraw from the program, request a leave of absence, or change your parent status.
Absence Verification Form	FOR STATE SUBSIDY PARENTS ONLY. Must be completed each time your child is absent.
Dietary Accommodations Form	Parents/legal guardians must complete this form if children have any food, milk or formula accommodations. You may also complete this form to decline participation in our food program.

Name	Description	Due Date
Medical Statement	Must be completed by a healthcare professional for children who need any food accommodation due to medical or disability reasons. Completed forms can be emailed to daisy.gutierrez@csulb.edu or submitted to the office.	On or before your child’s first day at IPCDC
Physician’s Report	Must be completed by a healthcare professional for all new incoming children. Completed forms can be emailed to daisy.gutierrez@csulb.edu or submitted to the office.	On or before your child’s first day at IPCDC