Childcare Needs Form – Critical Public Health or Public Safety Staff Childcare Needs Form

If you are an employee whose job duties are critical to protecting public health and/or public safety and are in need of childcare in order to work due to school closures please fill out the form below. Employees of the following critical services entities are eligible:

  • Hospitals/healthcare providers
  • Nursing homes
  • Long-term care facilities
  • Department of Health
  • Department of Mental Health
  • Department of Corrections
  • Department of Public Safety
  • Department of Social Services
  • County Health Departments
  • State, county, municipal law enforcement
  • Fire departments/fire protection districts
  • Ambulance districts

Click HERE for the form!