Illness Record
About the Illness Record
A comprehensive digital illness record designed to meet the requirements of Regulation 87 of the Education and Care Services National Regulations. This form captures illness details, symptoms, first aid administered, witness information, and conditional medication administration sections. The multi-step signing workflow ensures responsible person review and parent acknowledgement. Includes conditional fields for witness details and medication administration based on the circumstances of the illness.
Also called
- Sick child record
- Illness report form
- Unwell child record
What's on this form
Every question included in the illness record. Add, remove or reword any of them in the form builder.
Step 1 — Completed first
Filled in by the educator or responsible person
Child
Child details
Illness Details
Date Of Illness
Date
Time of Illness
Time
Session Type
- Before School Care
- After School Care
- Vacation Care
Choose one
Location of Illness
- Playground
- Arts and Crafts
- Playroom
- Kitchen
- Play Equipment
Choose one
Educator First On Scene
Short answer
Did anyone witness this illness?
Yes / No
Person who witnessed
Signature
Illness Description
Circumstances leading to the illness
Long answer
Description of illness
Long answer
Type of illness
- Cough
- Headache
- Sore Throat
- Sneezing
- Blocked Nose
- Fatigue/Tired
- High Temperature
- Respiratory
- Chills
- Aches
- Fever
- Poisoning
Choose any
Details of First Aid
Details of treatment including first aid administered
- Ice Pack
- Rest / Observe
- Disinfectant Wipe
- Saline Solution
- Band-Aid
- Compression Bandage
- Sling
Choose any
Description of First Aid Administered
Long answer
Person Who Administered First Aid
Educator signature
Parent / Guardian Notification Notes (If Applicable)optional
Long answer
Was Medication Provided
Yes / No
Call Parent & Ask These Questions
Parent Who Authorised Medication Administration
Short answer
Date Of Previous Medication
Date
Time Of Previous Medication
Time
Who previously administered the medication?
Short answer
Details of Medication Administration
Name of Medication
Short answer
Dosage Administered
Short answer
Method Of Administration
Short answer
Date Of Administration
Date
Time Of Administration
Time
Person who witnessed administration and checked dosage was correct
Educator signature
Step 2 — Responsible Person
Completed by a staff member at the service
RP To Complete
Regulatory Authority Contacted
Yes / No
Medical Personnel Contacted
Yes / No
Medical / Regulatory Comments (If Applicable)optional
Long answer
Educator / Person Completing Form
Educator signature
Responsible Person Details
Educator signature
Step 3 — Parent / Guardian
Sent to the parent or guardian to sign
Parent/Guardian Signature
Signature
How this form gets signed
This template runs as a multi-step signing workflow. Each person is notified in turn, and every signature is timestamped and stored against the record.
- 1
Responsible Person
Signs inside the service, using a staff PIN
- 2
Parent/Guardian
Signs externally — receives a secure link by email, no account needed
Australian regulations this form supports
The illness record is built around the Education and Care Services National Regulations. These are the regulations it helps you meet.
Incident, injury, trauma and illness policies and procedures
Services must have procedures for staff to follow when a child becomes ill while being educated and cared for.
Read the full text of Reg 85
The incident, injury, trauma and illness policies and procedures of an education and care service required under regulation 168 must include procedures to be followed by nominated supervisors and staff members of, and volunteers at, the service in the event that a child— (a) is injured; or (b) becomes ill; or (c) suffers a trauma.
Notification to parents of incident, injury, trauma and illness
Parents must be notified as soon as practicable, and no later than 24 hours after the occurrence — or alleged occurrence — of an incident, injury, trauma or illness.
Read the full text of Reg 86
The approved provider of an education and care service must ensure that a parent of a child being educated and cared for by the service is notified as soon as practicable, but not later than 24 hours after the occurrence, or alleged occurrence, if the child is involved in, or alleged to be involved in, any incident, injury, trauma or illness while the child is being educated and cared for by the education and care service.
Incident, injury, trauma and illness record
A record must include the child's name and age, circumstances, date/time, action taken, witnesses, notifications, and signatures.
Read the full text of Reg 87
(1) The approved provider of an education and care service must ensure that an incident, injury, trauma and illness record is kept in accordance with this regulation. (2) A family day care educator must keep an incident, injury, trauma and illness record in accordance with this regulation. (3) The incident, injury, trauma and illness record must include— (a) details of any incident in relation to a child or injury received by a child or trauma to which a child has been subjected while being educated and cared for by the education and care service or the family day care educator, including— (i) the name and age of the child; and (ii) the circumstances leading to the incident, injury or trauma; and (iii) the time and date the incident occurred, the injury was received or the child was subjected to the trauma; (b) details of any illness which becomes apparent while the child is being educated and cared for by the education and care service or the family day care educator including— (i) the name and age of the child; and (ii) the relevant circumstances surrounding the child becoming ill and any apparent symptoms; and (iii) the time and date of the apparent onset of the illness; (c) details of the action taken by the education and care service or family day care educator in relation to any incident, injury, trauma or illness which a child has suffered while being educated and cared for by the education and care service or family day care educator, including— (i) any medication administered or first aid provided; and (ii) any medical personnel contacted; (d) details of any person who witnessed the incident, injury or trauma; (e) the name of any person— (i) whom the education and care service notified or attempted to notify, of any incident, injury, trauma or illness which a child has suffered while being educated and cared for by the education and care service or family day care educator; and (ii) the time and date of the notifications or attempted notifications; (f) the name and signature of the person making an entry in the record, and the time and date that the entry was made. (4) The information referred to in subregulation (3) must be included in the incident, injury, trauma and illness record as soon as practicable, but not later than 24 hours after the incident, injury or trauma, or the onset of the illness.
Medication record
If medication is administered, a record must include the child's name, medication name, dosage, time, and signatures.
Read the full text of Reg 92
(1) The approved provider of an education and care service must ensure that a medication record is kept that includes the details set out in subregulation (3) for each child to whom medication is or is to be administered by the service. (2) A family day care educator must keep a medication record that includes the details set out in subregulation (3) for each child being educated and cared for by the educator as part of a family day care service to whom medication is or is to be administered. (3) The details to be recorded are— (a) the name of the child; (b) the authorisation to administer medication (including, if applicable, self-administration), signed by a parent or a person named in the child's enrolment record as authorised to consent to administration of medication; (c) the name of the medication to be administered; (d) the time and date the medication was last administered; (e) the time and date, or the circumstances under which, the medication should be next administered; (f) the dosage of the medication to be administered; (g) the manner in which the medication is to be administered; (h) if the medication is administered to the child— (i) the dosage that was administered; and (ii) the manner in which the medication was administered; and (iii) the time and date the medication was administered; and (iv) the name and signature of the person who administered the medication; and (v) if another person is required under regulation 95 to check the dosage and administration, the name and signature of that person.
Provided for information only and may not reflect the latest amendments. Refer to the Education and Care Services National Regulations (NSW) for the official legal text.
Where this form fits
The illness record is part of these jobs — each guide walks through the whole sequence and the other forms that go with it.
Vacation care forms: excursions, transport and bus checks
What a school holiday program actually runs on — an authorisation for each excursion, transport consent, and the embarking and disembarking checks.
Daily records: what educators fill in as things happen
The records your staff complete during the day — incidents, illness, medication given, and observations of children’s learning.
Forms your educators fill in
The records staff complete — incidents and illness, medication given, observations, safety checks and transport.
Questions about the illness record
What is the illness record used for?
A comprehensive digital illness record designed to meet the requirements of Regulation 87 of the Education and Care Services National Regulations. This form captures illness details, symptoms, first aid administered, witness information, and conditional medication administration sections. The multi-step signing workflow ensures responsible person review and parent acknowledgement. Includes conditional fields for witness details and medication administration based on the circumstances of the illness.
Who fills in the illness record?
The illness record is completed by educators or the responsible person at the service. Staff open it on any device and sign with a service PIN, so there's no separate login to manage. It then moves through 2 signing steps — Responsible Person and Parent/Guardian — with each signature timestamped against the record.
Which Australian regulations does the illness record meet?
It is built around Reg 85, Reg 86, Reg 87 and Reg 92 of the Education and Care Services National Regulations. Reg 85 covers incident, injury, trauma and illness policies and procedures. Reg 86 covers notification to parents of incident, injury, trauma and illness. Reg 87 covers incident, injury, trauma and illness record. Reg 92 covers medication record. Every question the regulations require is already on the form.
Is the illness record the same as a sick child record?
Yes. Different services use different names for this form — it is also called sick child record, illness report form and unwell child record. They all describe the same record, and this template covers it. You can rename it to whatever your service already calls it.
Can I change the questions on the illness record?
Yes. The template comes with 38 fields ready to go, but you can add, remove, reword or reorder anything in the drag-and-drop form builder, and add your own conditional logic and signing steps. Your changes only affect your service's copy.
Is the illness record free?
Yes — the illness record is free to use on the Childcare Forms free plan. No credit card is required to create an account and start sending it.
Ready to use it?
Create a free account, change anything you want, and send it to your first family. No credit card needed.