Inclusion Program Forms

These forms are used when the Cocokids’ Inclusion Program provides services in child care settings in Contra Costa County, California. Please contact the Inclusion Program by calling  (925) 676-5442 ext. 3113 or by sending and e-mail, to request help before sending the forms.

Parent Inclusion Packet:

  • The Consent to Provide Services and Exchange Confidential Information must be signed by the child’s parent or guardian before Inclusion Program services can be provided in the child care program.
  • The Parent Questionnaire helps our Inclusion Facilitators learn about a child’s needs so we can provide appropriate assistance.
  • The First 5 Contra Costa Family Survey is a survey requested by the people who help fund our Inclusion Program services.

View and print the 

Provider Inclusion Packet: Inclusion Parent Packet

  • The Inclusion Program Provider Contract must be signed by the child care provider before Inclusion Project services can be provided in a child care program.
  • The Provider Questionnaire helps our Inclusion Facilitators learn more about the child who needs our support.
  • The First 5 Contra Costa Provider Survey, helps First 5 Contra Costa improve services for young children and families in Contra Costa County.

View and print the Inclusion Provider Packet


Embracing Families Project, Inclusion School Age Program:


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