GO Team Support Request
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
City
*
County
*
How would you classify yourself?
*
Child Care Provider
Family Member
Business/Employer
Community Leader
Elected Official
Child Care Support Organization Representative
Other
Describe your role and involvement in child care or the concern you are seeking support for.
*
Name of Facility
*
Must be the owner/operator, director or authorized representative
License Number
*
License Type
*
Family Child Care (FCC)
Child Care Center (CCC)
Preschool
School-Age Program
Drop-In Program
General Nature of Concern
*
Operational (staffing, financial, enrollment)
Systems Navigation (insurance, appraisals, HOA)
Licensing and Regulation (Kansas Department of Health and Environment, Kansas Fire Marshal)
City / County (zoning, codes ordinances)
Disaster or Emergency (natural disaster, death, unexpected closure)
Impending Program Closure
Funding Exploration
Other
Details of Concern
*
Describe upcoming timelines/deadlines or events related to this situation
*
File Upload (If Any)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Urgency Level
Today
In the next 48 hours
This week
Not Urgent
How would you like to be contacted?
Either phone or e-mail
By phone
By e-mail
Have you contacted any of the following organizations regarding this concern
*
Kansas Department of Health and Environment
Kansas Fire Marshal
Department for Children and Families
Kansas Children's Cabinet and Trust Fund
City or County Administration
Local Child Care Coalition
Local or State Elected Officials
Child Care Resource and Referral Agency (Futures First, Child Start, Child Care Aware of Eastern Kansas)
Child Care Provider Support Programs (Links to Quality, Quality Improvement Coach, Kansas Child Care Training Opportunities)
Community Support Agencies or Advocacy Organizations
Legal Representative
None
Please share any additional details that may help us better understand your situation.
Support Expectations and Disclaimer
Response timelines may vary depending on the complexity of your situation and current caseload, within 5 business days we will be reaching out for further information and data collection. Some concerns may require coordination with multiple agencies and may take additional time to address. While we strive to provide helpful guidance and support, not all situations will have an immediate or direct resolution. In some cases, the information you provide may help inform broader system improvements over time. NOTE: We do not provide legal advice and do not engage in advocacy with elected officials on behalf of individuals organizations. We can provide education, resources, and relevant data to support informed decisions.
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