Subsidy Questionnaire | HealthyKidsPrograms

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FIND YOUR LOCATION

Take this quick questionnaire to find out if you could qualify for child care assistance!

First Name

Last Name

Email

Do you live in NYS?

Are your children citizens or have satisfactory immigration status?

Do you meet one of the following?

Do you fall under one of the following income levels?

Family of 2 $67,490.17 Annual Income Limit

Family of 3 $83,370.21 Annual Income Limit

Family of 4 $99,250.25 Annual Income Limit

Family of 5 $115,130.29 Annual Income Limit

Family of 6 $131,010.33 Annual Income Limit

I attest that I have answered this form honestly and accurately.

Thanks for submitting! Our Subsidy Specialist will be in touch with the results of the questionnaire and next steps via email.

GET IN TOUCH

Need answers fast? Chat with us now! Or fill out the form below, and we’ll be in touch shortly!

Email

Phone Number

Where are you located?

Message

Are you a new family to Healthy Kids? *

Yes

No

Thanks for submitting!

MAIN OFFICE ADDRESS

📍2 Summit Court

Fishkill, NY 12524

PHONE

845-330-0200

FAX

845-765-0036

Thanks for submitting!

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