Inclusion Forms

These forms are used when the Child Care Council’s Inclusion Project provides services in child care settings in Contra Costa County, California. Please contact the Inclusion Project¬†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 Project 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 Project services.

View and print the Inclusion Parent Packet

Provider Inclusion Packet:

  • The Inclusion Project 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