The Minnesota daycare health care summary form, officially form MS-2083, is a one-page report that your child’s doctor, nurse practitioner, or physician assistant completes to confirm your child has had a current physical exam and to flag any health conditions the child care program needs to know about. Every child enrolled in a licensed child care center or family child care home in Minnesota needs one on file, and the program must have it before your child is admitted or within 30 days of the first day of attendance.1Minnesota Office of the Revisor of Statutes. Minnesota Rule 9503.0140 – Health
Where to Get the Form
The form is posted on the Minnesota Department of Children, Youth, and Families (DCYF) website on both the licensed child care centers forms page and the family child care providers forms page.2Minnesota Department of Children, Youth, and Families. Forms for Licensed Child Care Centers Most programs will also hand you a blank copy at enrollment. As of June 2025, child care licensing moved from the Department of Human Services to DCYF, so older printed copies you encounter may still carry DHS branding. They remain the same form.3Minnesota Department of Human Services. Licensing Transition From the Department of Human Services to the Department of Children, Youth, and Families
What You Fill Out
The top of the form is for the parent or guardian. You enter your child’s name, date of birth, address, and phone number, the date of enrollment, and your name. Make sure the enrollment date matches what the facility has on record, so there’s no confusion about when the 30-day deadline runs.
What the Health Care Provider Fills Out
The rest of the form is for your child’s doctor, physician assistant, or nurse practitioner. The provider is asked to supply:
- The date of the last physical exam, which is the key piece of information the facility uses to confirm the exam is current.
- How long and how often they have been seeing your child.
- Any allergies, including medication allergies, with enough detail for staff to avoid triggers.
- Any medically required diet modifications.
- Any condition that could cause a medical emergency during care hours, such as seizures, severe allergic reactions, or diabetes.
- Vision, hearing, and speech status, with notes on whether each is normal or needs monitoring.
- Important ongoing health problems, with a note on whether each needs special attention at child care.
- Any additional information the program should know.
The provider signs and dates the form and adds the office address and phone number. The simplest way to get it done is to bring the blank form to your child’s next well-child visit or physical, so the provider completes it during the appointment. A separate visit just for the form is usually unnecessary if a routine checkup is already coming up inside the 30-day window.
Immunization Records Are Separate
Immunizations are a different requirement, though both must be on file at enrollment. Under the same rule, the facility must collect proof of current immunizations or a signed exemption when your child enrolls.1Minnesota Office of the Revisor of Statutes. Minnesota Rule 9503.0140 – Health Minnesota follows the schedule recommended by the American Academy of Pediatrics.4Minnesota Department of Health. Vaccines for Infants, Children, and Adolescents
Two exemptions are allowed. A medical exemption requires a licensed physician, nurse practitioner, or physician assistant to sign a statement that a particular vaccine is medically contraindicated for your child or that lab results show your child is already immune. A non-medical exemption requires you to sign a notarized statement that one or more immunizations conflict with your personal beliefs.5Minnesota Department of Health. Minnesotas Immunization Law Exemption Provision The Minnesota Department of Health publishes a combined immunization record and exemption form for child care programs, which your provider can supply or you can download from the Department of Health.6Minnesota Department of Health. Child Care and Early Childhood Programs Immunization Law
When You Need a New Form
How often you need to submit an updated Health Care Summary depends on your child’s age.1Minnesota Office of the Revisor of Statutes. Minnesota Rule 9503.0140 – Health
- For children under 24 months, the facility must obtain an updated physical exam report at least once a year. Infants see their doctor frequently anyway, so tying the update to a scheduled well-child visit usually keeps the form current without extra appointments.
- For children 24 months and older, a new report is required whenever your child moves to an older age category at the facility. The age groupings vary by program, but a common transition is from a toddler room to a preschool room. Ask your provider which age categories they use so you know when another form is due.
Even when the rule does not yet require an update, it is worth getting a fresh form after any visit that produces a new allergy, diagnosis, or medication. The staff can only accommodate what they know about.
How to Submit It
Hand the completed form to the center director or family child care provider at drop-off. Some facilities accept scanned uploads through a parent portal, but a paper copy is always fine. The form goes into your child’s individual record at the facility and must be available for review by DCYF licensing staff during inspections.7Minnesota Office of the Revisor of Statutes. Minnesota Rule 9503.0125 – Childrens Records
What Happens If the Form Is Missing or Late
If a DCYF inspector finds that your child’s Health Care Summary is missing or out of date, the usual first step is a correction order that identifies the rule violated and gives the provider a deadline to fix it. Standard fines for a rule violation are $100 per incident, but because a missing health form is health-and-safety related, the fine rises to $200 per violation.8Minnesota Department of Children, Youth, and Families. FAQs About Licensing Actions Expect reminders from your provider as the 30-day deadline gets close.
Special Health Needs and Accommodations
If your child has a chronic condition, a disability, or complex medical needs, the Health Care Summary is often the starting point for a wider conversation. The information on the form alerts the provider that additional planning may be needed. Under the Americans with Disabilities Act, child care providers must make reasonable modifications based on each child’s individual abilities rather than acting on assumptions, and the provider should talk with you and your child’s health care professionals about what adjustments make sense.
Children receiving early intervention services usually have an Individualized Family Service Plan (IFSP) that sets out services and supports across all settings. The Health Care Summary does not replace an IFSP. The two work together: the summary gives the program a medical snapshot, and the IFSP lays out developmental goals and specific accommodations. Share both so staff have the full picture.