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Verification for Need for Child Care - Special Needs This form is filled out when there is a Special

Verification for Need for Child Care - Special Needs This form is filled out when there is a Special 2025

Verification for Need for Child Care - Special Needs This form is filled out when there is a Special Preview on Page 1

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The document is a verification form for the need for child care subsidies specifically for children with special needs. It collects personal information in compliance with privacy laws and requires completion by an authorized professional who confirms the child's need for additional support services due to various special needs. The form also includes sections for the professional's details and a signature, along with instructions regarding annual resubmission if no end date is provided.

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