Child Care Enrollment Application For Dependents of NYC Health + Hospitals Employees

Please complete this form to apply for high-quality care for your children. Child care services include 24/7 access to a network of vetted and accredited child care centers and in-home caregivers. Click here to read frequently asked questions.

Employee Information

(for internal use related to FEMA reimbursement only)
Your Employee ID is your 9-digit TKID number found on the backside of your Employee Photo-ID Card
(days/hours when you need child care services)
Dependent(s) Information

Child # 1:
Child # 2:
Child # 3:
Child # 4:
Child # 5:
  • I am an active employee of NYC Health + Hospitals.
  • Each of the children in this form are my dependents.
  • I am unable or ineligible to access the child care services offered by New York City Department of Education. (Includes employees currently using DOE services, who need additional child care services.)
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