CHILD CARE SURVEY
Child care survey for essential health care workers
In accordance with state guidance, Edinburg Common School District is planning to facilitate arrangements with our community partners to provide child care for essential health care workers in our community during the COVID-19 (coronavirus) outbreak. This service would only be available for those who work in positions identified by the state: physicians, nurse practitioners, physician assistants, registered nurses, LPNs, nurse assistants, laboratory personnel, paramedics, EMTs, police officers and firefighters.
What is your occupation?
Do you need child care immediately?
Do you anticipate needing child care during the coronavirus outbreak?
Contact Information (Please Fill-In Contact Information Below)
Name
Address
City/Town
Zip Code
Email Address
Phone Number
Contact Information
Your answer
Please list the names and ages of your children who would need child care:
Your answer
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This form was created inside of Edinburg Common School.