Explore & Discover
A Highlands Early Learning Cooperative
3401 West 29th Avenue, Denver, CO 80211
Phone/Fax: (720) 855-6818
Email: eandddirector@gmail.com
www.exploreanddiscover.org
Diaper Rash Cream Permission
Explore and Discover does not provide diaper rash cream.
Please complete this form if you wish to bring diaper cream for your child.
This permission slip is for daily use of over the counter diaper cream. The cream named on
this permission form is the only diaper rash cream E&D staff is authorized to apply to your
child. If the cream is expired, the parent will be given the cream to take home for disposal.
E&D staff may not apply diaper rash cream to open wounds or broken skin. If your child
develops a rash with open wounds or broken skin, a written order by the prescribing
physician is required. In such a case, please use the medication administration forms on
the website.
I give permission for the staff at Explore and Discover to apply
(name of diaper rash cream provided)
to my child,
, given these circumstances
(child’s first and last name)
(please specify the frequency, i.e. every diaper change, when a rash is present, only with
disposable/cloth diapers)
I understand that the staff will never use the cream on open wounds or broken skin.
Parent / Guardian Signature and Date
All medications, including over-the-counter diaper rash cream, must be in
the original containers with the child’s first and last name clearly labeled.
CREAMS AND LOTIONS MAY NOT BE STORED IN PLACES ACCESSIBLE
TO CHILDREN, SUCH AS CUBBIES OR DIAPER BAGS.
Diaper Rash Cream Permission, Updated 10/2014
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