Navpers Family Care Plan Arrangements Page 2
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3FAMILY CARE PLAN ARRANGEMENTS
NAVPERS 1740/7 (Rev. 02-2011)
Supporting Directive OPNAVINST 1740.4
2. LOGISTICAL ARRANGEMENTS
:
(CONTINUED)
SCHOOL ARRANGEMENTS
(MAY NOT BE ABLE TO ENROLL CHILD IN SCHOOL WITHOUT COURT ORDER)
ACCESS TO AND USE OF GOVERNMENT SERVICES
(COMMISSARY, EXCHANGE, ETC.)
NON-MILITARY ESCORT FOR FAMILY MEMBERS NEEDING ASSISTANCE
(CHILDREN, ELDERLY, DISABLED)
CELL PHONE:
NAME::
PHONE:
ADDRESS:
E-MAIL:
ADDITIONAL COMMENTS:
3. MEDICAL/HEALTH CARE SERVICES:
IN LOCO PARENTIS POWER OF ATTORNEY TO ALLOW TREATMENT OF CHILDREN
EXPLAINED INSURANCE AND MEDICAL PAYMENT METHODS
IDENTIFIED CURRENT HEALTH CARE CONCERNS AND ON-GOING TREATMENTS
PROVIDED LOCATION OF MEDICAL FACILITIES
NAME OF FACILITY:
PHONE:
ADDRESS:
PROVIDED NAME OF MEDICAL, DENTAL AND OTHER HEALTH CARE PROVIDERS
DOCTOR:
DENTIST::
ADDITIONAL COMMENTS:
4. EDUCATIONAL FACILITIES LOCATION:
IDENTIFIED EDUCATIONAL FACILITIES
NAME OF SCHOOL:
PHONE:
ADDRESS:
PRINCIPAL:
CONTACTED SCHOOLS AND LOCAL BOARD OF EDUCATION FOR ENROLLMENT INFORMATION
EDUCATIONAL/CHILDCARE FACILITIES WILL ACCEPT CHILDREN
Page 2 of 3
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