Child Development Center - Current Families
MercyOne Dubuque Child Development Center and Preschool provides quality care for the children of MercyOne colleagues and affiliates.
Phone: 563-589-9680 | Fax: 563-589-9559 | Email: dqcdcsch@mercyhealth.com
Current Family Forms
HEALTH FORMS
- Health Form (must be signed by a medical professional)
- Immunization Form (must be signed by a medical professional)
WITHDRAWAL FORM
To officially withdraw from MercyOne Dubuque Child Development Center and Preschool, families shall complete this form and return to the director.
ANNUAL RE-ENROLLMENT FORMS
- RE-Enrollment Verification Form (submit 1 per child)
- Child and Adult Care Food Program Form
RATE SHEETS
Benefit-eligible MercyOne/Trinity colleague:
- Violet, Indigo, Blue, Green, Teal, Yellow, Orange, and Red Rooms (submit 1 per child)
- Rainbow Room ages 5 – 9 (submit 1 per child)
Non-MercyOne/Trinity colleague and non-benefit eligible MercyOne/Trinity colleague:
- Violet, Indigo, Blue, Green, Teal, Yellow, Orange, and Red Rooms (submit 1 per child)
TUITION ASSISTANCE
Submit one per eligible family
- Tuition Assistance Application Form (for full or part-time benefit-eligible MercyOne/Trinity colleagues)
Benefit-eligible is any MercyOne/Trinity colleague who is budgeted to work 32 hours or more per pay period.
OTHER
- Diet Modification/Food Allergy Form (submit 1 per child with a food allergy)
- Care Plan Form (submit 1 per child with a food allergy or other health/developmental need)
- School Age Health Form (submit 1 per school age child, ages 5 – 9)
