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.

• Withdrawal Form

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)