For
Child Care
Providers

Program Forms & Documents

The following items are resources for each of our programs and services. For parents and child care providers who participate in our programs, please consult with a Program Specialist about which forms are required of you. If you would like to have a document or form mailed to you, or if you have any questions about these items, please contact your local CHS office.

Child Care Payment Program (CCPP) – For Providers

CCPP Written Information to Providers
CCPP Written Info to Providers - Acknowledgment of Receipt

Child Care Resource and Referral Program (R&R)

Appeal Policy
Complaint Policy
Child Care Referral Policy
Choosing Child Care Brochure
Resource & Referral Provider Update Form
Resource & Referral Brochure

Family Child Care Home Education Network (FCCHEN)

FCCHEN Written Information to Providers
FCCHEN Written Information to Providers - Acknowledgment of Receipt

Family Education Program (FEP)

Family Education Program Material Request Form

Helpful Forms

Affidavit Regarding Liability Insurance
Declaration of Exemption from TrustLine Registration and Health & Safety Self-Certification
Direct Deposit Form
Health & Safety Self-Certification CCP4 Form
Lost-Stolen Check Affidavit
Trustline Application
TrustLine Registry Criminal Record Statement
W-9 Request for Taxpayer Identification

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