I don't ask for notes. A lot of doctors charge $20 or more to write a note like that. I use my common sense and my clear contract policy. I go by my fever policy and no open sores policy. Once a child has a full blown virus like this (sounds like Hand Foot and Mouth to me) the other children have already been exposed so you can't win there. However, a sick child who feels crappy wants to be home with a parent and chances are they can't participate and have fun at daycare.