Get New Provider Intake Form - Child Care Links

The New Provider Intake Form is essential for individuals interested in providing childcare services. This guide offers clear instructions to help users fill out the form accurately and efficiently in an online format.

Follow the steps to complete the New Provider Intake Form with ease.

1. Press the ‘Get Form’ button to obtain the New Provider Intake Form and open it in your preferred online editor.
2. Begin by filling in your personal information, including your name, business name, and facility number. Ensure to enter the license effective date accurately.
3. Provide your facility's address along with the nearest cross street, city, zip code, and contact numbers for phone and cell phone.
4. Indicate the local school associated with your childcare services and specify the capacity of your facility.
5. Enter your email address for correspondence purposes and indicate the ages you are willing to provide care for, specifying the youngest and oldest ages.
6. Fill in your operating hours by stating the start and end times. Indicate if your schedule is flexible.
7. Check all applicable types of care you will provide, including part-time, full-time, drop-in, year-round, weekend, night care, before school, and after school options.
8. In the special services section, indicate if transportation is provided, specify meals served, and describe your food program and any foreign languages offered.
9. Check all relevant training credentials, such as CPR/First Aid and other professional development courses you have completed.
10. In the education section, specify your academic units, degrees, and certifications related to early childhood education.
11. Identify any special needs training, including areas like medical needs, communication, and developmental delays, as applicable.
12. Enter your rates for childcare services based on age and type of care (full-time or part-time). Be specific with weekly rates.
13. Indicate whether you participate in the CCL subsidy program by selecting yes or no.
14. Describe your home environment by noting any pets or features like a pool or spa.
15. List any current openings you have, specifying the age group and shift time available.
16. Remember to attach a copy of your license when submitting the completed form to Child Care Links.
17. Once all fields are filled out, save your changes and download or print the form for your records before sending it.

Start filling out the New Provider Intake Form online today to provide essential childcare services.