• Foster Village Houston Caregiver Request Form

  •  -
  • If kinship, are you a licensed kinship family?*
  • What was the date of licensing? *
     - -
    2 digit month, 2 digit day, 4 digit year
  • When did the child arrive in your home?: *
     - -
    2 digit month, 2 digit day, 4 digit year

  • Items Requested

  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Does this child need pillows?*
  • Does this child need textured haircare products? (ages 2+)*
  • What products are needed?*
  • Are you interested in Project SOOTHe for this child? If "Yes", someone will follow up with you. (Through Project SOOTHe, we provide sensory objects such as weighted blankets, swings, sensory toys, and white noise machines that can help ease anxiety for children.)
  • Delivery Options*
  • Delivery Options*
  • Please verify that the name at the top of the form is the CAREGIVER'S first and last name:*
  • Should be Empty: