Alabama child placing agencies and residential child care facilities need a medical report showing that foster or adoptive parents and staff can safely care for children. On this one-page form the examiner records a Mantoux TB test, medications that affect alertness or driving, physical limitations and observed psychological or emotional concerns, then states the person is free of infectious disease and physically fit.
A medical doctor, physician assistant or certified nurse practitioner completes everything below the applicant's authorization and signs. The applicant fills in their name, agency or facility and position and signs the authorization to release the report.
Download the current version from the source each time; forms change without notice.
Medical Report for Child Placing Agencies / Residential Child Care Facilities
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The form calls for an initial intradermal tuberculin (Mantoux) test, repeated every two years if no extenuating circumstances exist. If the Mantoux is positive, the examiner records the date and result of a chest X-ray.
A medical doctor, physician's assistant or certified nurse practitioner who performed the exam. The examiner prints their name, signs and dates below the statement that the person is free of infectious or contagious disease and physically fit to care for children.
Foster and adoptive parents and staff members of licensed child placing agencies or residential child care facilities in Alabama. The applicant's authorization explains that the exam determines their physical, psychological and emotional ability to care for children and perform services in the agency or facility.