Asthma-Friendly Child Care Center Assistance Request

General Information

Thanks for your interest in earning the Asthma-Friendly Child Care Center Recognition! Please fill out the information below so we can help you get started.

BACKGROUND: The Florida Asthma Coalition is working to improve the quality of life of individuals with asthma across the state. Child care providers play a key role in protecting children's safety, and also have the opportunity to improve their overall health and well-being for a lifetime. The Asthma-Friendly Child Care Center Recognition opportunity was designed to encourage and help child care center administrators and staff provide the best environment and care for children with asthma.

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Child Care Center Name:

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County:

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Is this a Head Start or Early Head Start Center?

Yes

No

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Please provide your contact information:

Name:

Position Title:

Phone Number:

E-Mail Address:

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Please provide the name and contact information for other staff who may be assisting you in achieving the Asthma Friendly Child Care Center Criteria.

Name:

Position Title:

Phone Number:

E-Mail Address:

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How did you hear about this recognition opportunity?

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Is there anything the Florida Asthma Coalition can help you with right away? (Please note, we may not be able to meet all needs, but sharing your most pressing concerns will help us assist with your top priorities first)