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Scott County Health Departmental for Kids Referral Form Referral Date: ___ Referred by : ___ (i.e. doctor, school nurse, social worker) Whom may we contact at your office if we have questions about
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How to fill out care for kids referral

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How to fill out care for kids referral

01
Obtain a care for kids referral form from a healthcare provider or social service agency.
02
Fill out the form completely with accurate information about the child in need of care.
03
Provide details about the child's medical history, current medications, allergies, and special needs if any.
04
Include contact information for the child's parent or guardian and any other relevant individuals involved in the child's care.
05
Submit the completed referral form to the appropriate agency or organization for processing.

Who needs care for kids referral?

01
Parents or guardians seeking additional support for their child's care needs.
02
Healthcare providers identifying a child who may benefit from additional services.
03
Social service agencies working with families in need of childcare assistance.
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Care for Kids referral is a program that assists families in accessing financial support for childcare services, aimed at promoting early education and ensuring children are well cared for.
Parents or guardians seeking financial assistance for childcare are required to file a care for kids referral.
To fill out a care for kids referral, individuals must complete the designated application form, providing necessary information such as family details, income, and childcare needs.
The purpose of care for kids referral is to facilitate access to affordable childcare services for eligible families, thereby enabling parents to work or pursue education.
The care for kids referral must report information including family income, number of children needing care, the type of childcare required, and the duration of care needed.
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