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Child Care Needs Form

In order to find the best match for you and your children’s needs, please complete the following information. Referral requests will be processed and disbursed within 1-5 business days depending on the specific requests and referral volume. The information provided is for referral purposes only. Child Care Referral Program does not warrant the information concerning any provider, nor do we license, endorse, or recommend any particular provider. Only you can determine whether the quality of care is appropriate for your child by thorough screenings and visits with the provider prior to care being provided.