Let's Continue

Great! Based on your responses, your child appears to meet our basic eligibility requirements. The next step is to complete our intake form for each child. Once this form has been completed, our Strong Families Team will contact you to schedule a brief intake meeting. At that meeting, please be prepared to provide:

• Child's Social Security Number
• Child Health Report completed by the child's physician
• Primary Care Provider information
• Health insurance card (front and back)
• Parent/Guardian photo ID (front)

Complete Intake Form