Request Child Care Form

There are several ways for families to receive free referrals from Child Care Aware of Virginia.

  1. Call (866) 543-7852 option 2 for our customized referral service
  2. Complete and submit the on-line form below

Once completed and submitted, this online form will be sent to our Consumer Education Specialist.  Once the form is received your search will be conducted no later than the next business day.  You will receive an email with information on child care programs that meet your needs along with additional information in choosing a quality child care site.

You Should Know…Child Care Aware of Virginia provides information about child care programs, not recommendations. We do not endorse, regulate, or monitor child care. Parents are encouraged to visit and interview providers before making a final decision about their child care.

All fields marked with “*” must be completed before this form can be submitted.

Child Care Search Form

Form for parents to submit when looking for child care
  • Search Criteria

  • Demographic Information