Children's Early Childcare Provider Survey

Hello! Thank you for taking the time to complete this survey, which will ask about your preferences for receiving outreach materials from the Office of MaineCare Services. If you have any questions, please contact Sarah Fisher at Sarah.Fisher@maine.gov or 207-624-4096.

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* 1. Please provide your organization's name.

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* 2. Please provide your organization's address.

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* 3. Please provide the appropriate point of contact at your organization for receiving outreach and educational materials from the Office of MaineCare Services (name, phone number, email address). Would you prefer to be contacted by phone or email?

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* 4. Which of the following Cub Care materials would you be interested in having for your organization? Please select all that apply.

Posters

Rack card (4"x9")

Flyer to provide to families

Fact sheet to provide to families

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* 5. For the option(s) that you chose above, how many of each do you want?

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* 6. Would you like materials translated into any additional languages?

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* 7. What is the best way to distribute the material(s) to you?

Send a PDF over email

Mail physical copies to your organization

Children's Early Childcare Provider Survey

Question Title

* 1. Please provide your organization's name.

Question Title

* 2. Please provide your organization's address.

Question Title

* 3. Please provide the appropriate point of contact at your organization for receiving outreach and educational materials from the Office of MaineCare Services (name, phone number, email address). Would you prefer to be contacted by phone or email?

Question Title

* 4. Which of the following Cub Care materials would you be interested in having for your organization? Please select all that apply.

Question Title

* 5. For the option(s) that you chose above, how many of each do you want?

Question Title

* 6. Would you like materials translated into any additional languages?

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* 7. What is the best way to distribute the material(s) to you?

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* 8. Are there any additional resources you would find helpful?