Child Care Choices
"Your Link to Community Child Care in Miami County"

 

Request for Child Care Referrals

Welcome! For child care referrals, please complete ALL fields to enable the Child Care Choices staff to give you referrals that most closely meet your child care needs.. A Referral Specialist will process your request within 2-3 working days. If you have questions regarding your child care options, please call and ask to speak to a referral specialist.
937-667-1799
1-866-667-4799 (toll free)
Child Care Choices makes referrals only, not recommendations.

Note: Child Care Choices believes parents are best able to evaluate and choose childcare for their children because they are in the best position to evaluate their children's needs. The goal is to assist parents in finding the widest range available for childcare, and to encourage parents to act on their own knowledge and feelings as they select among these possibilities. Responsibility for selecting and employing a childcare provider rests with each parent. Child Care Choices does not monitor the quality, nor does it recommend, the providers listed with the service. Parents are urged to carefully interview and check references before leaving a child in care.

Privacy policy: The information you provide on this page will be used to report aggregate demographic data to our funders and communities. Individual client data is kept confidential. You may be contacted by Child Care Choices for voluntary client satisfaction feedback. Contact will be made by email, postal mail or telephone depending on the contact information you provide. Child Care Choices does not share or sell mailing lists or client names.

CHILD CARE CHOICES OHIO INTAKE
Click on Submit when ready to send.

Your Name:
Street Address:
City: State:    

 Zip Code: 

Neighborhood/Region:
Phone:
E-mail Address: (Include if you want us to send you referrals through e-mail)
Age of parent:
Location for child care:
Employer:

(Complete the work address section if you are requesting child care referrals near work location.)
Work Address:
City:   State:     Zip Code: 
Phone:
Non-Smoking:
Are you eligible for public subsidy?
How soon do you need care? (provide date)
Ages of children needing care:
Birth dates of children needing care:
Days care needed: Sunday  Monday  Tuesday  Wednesday 
Thursday  Friday  Saturday
Hours care needed: From:     To: 
Type of Care: Center  Family Child Care Home  Preschool  
  If school age, please provide name of school: 

Response to the following questions is optional:
Household income:
Household size:
Single Parent: Yes    No
Spanish/Hispanic/Latino: Yes    No
Race:
Any additional comments or special instructions?
How did you hear about Child Care Choices?

 

 

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Child Care Choices
814 West Main Street
Tipp City, Ohio 45371
937-667-1799
Toll free telephone #1-866-667-4799
FAX 937-667-0819
Betsy Russ, Director
e-mail CCC