Emergency Child Care Needs in Dare County During COVID-19 Response

This survey is intended for those with child care needs who work in essential services needed especially during this COVID-19 event. Please identify whether your job is “essential” such that you are not able to work from home and need to continue despite any workforce restriction. Thank you for your assistance in helping us plan how to met emergency child care needs!

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* 1. Please check the essential work you perform

First Responder - EMS

First Responder - Fire Department

First Responder - Law Enforcement

First Responder - Coast Guard

Hospital Staff

Front-line Healthcare Provider

Nursing Home Staff

Child Care Program Staff

Food Service Staff

Other Essential Care

Care for children in unstable, unsafe living arrangements

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* 2. Are you currently in need of child care?

Yes

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* 3. Do you have family or friends or other resources to help you care for your child(ren) at this time while helping maximize social distancing?

Yes

Sometimes

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* 4. If you answered "Sometimes", please tell us more about the limitations of available help (e.g., weekends only, evenings only, Wednesdays only, etc.)

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* 5. Please tell us the number of your children who need care

5 or more

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* 6. Please check the ages of all your children who need care

Infant and Toddler

Potty-trained Preschool Children (3 and 4 year olds)

Elementary Age (K-5)

Middle School (6-8)

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* 7. Please tell us the hours your children need care

Daytime

Evening or Nights

Weekend

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* 8. If your work hours vary widely and there are special hours your children need care, please enter

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* 9. I do not currently need help with child care but may if emergency circumstances due to the virus change

Yes

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* 10. Please enter your name, address, and best contact information

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number