Please fill out all information in order to get your application started. Staff will be contacting you within one week to get the rest of your information.
Parent/Guardian
If available, please use the mother of the child as the primary adult unless she is not living in the home.
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Email Address (Required)
Confirm Email Address
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Mobile Phone
Opt In for Text Messages
Yes
No
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
SSN
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Other Language
American Sign Language
Amharic
Arabic
Chinese
Chuukese
Dinka
English
French
Gujarati
Kiche
Korean
Mai Mai
Micronesia
Mum
Portuguese
Spanish
Swahili
Tigrinya
Twi
Ukranian
Vietnamese
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
General Education Diploma
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Graduate
Master's Degree
Employment Status
Full-time (35 hours/week or more)
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Lives with Family
Yes
No
Address
Please complete the following information
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
Click here
to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
Email Address
Confirm Email Address
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Mobile Phone
Opt In for Text Messages
Yes
No
Home Phone
Work Phone
Ext.
It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Other Language
American Sign Language
Amharic
Arabic
Chinese
Chuukese
Dinka
English
French
Gujarati
Kiche
Korean
Mai Mai
Micronesia
Mum
Portuguese
Spanish
Swahili
Tigrinya
Twi
Ukranian
Vietnamese
Highest Grade Completed
Associate's Degree
Bachelor's Degree
College Degree/Training Cert.
College or Advance Training
General Education Diploma
Grade 10
Grade 11
Grade 12
Grade 9 or less
High School Graduate
Master's Degree
Employment Status
Full-time (35 hours/week or more)
Part-time (Under 35 hours/week)
Retired or Disabled
Seasonally Employed
Training or School
Unemployed
Child's Relationship
Biological/Adopted/Step
Foster
Grandchild
Other
Other Relative
Custody
Yes
No
Lives with Family
Yes
No
Family Information
please complete the following information. We will need a copy of your tax information, W2's, or any other income you may have in your household. We will be contacting you shortly for this information. Regarding your emergency contacts, you as parents or guardians will always be contacted first. These extra contacts can be grandparents, aunts/uncles, friends, etc. Please check whether we can contact them in case of an emergency AND if we have permission to release the child to them
Number of Parents/Guardians
One Parent Family
Two Parent Family
Relationship to Participant(s)
Foster parent(s) not including relatives
Grandparent(s)
Other
Parent(s) (e.g. biological, adoptive, stepparents)
Relative(s) other than grandparents
Primary Language at Home
American Sign Language
Amharic
Arabic
Chinese
Chuukese
Dinka
English
French
Gujarati
Kiche
Korean
Mai Mai
Micronesia
Mum
Portuguese
Spanish
Swahili
Tigrinya
Twi
Ukranian
Vietnamese
Number in Family
Gross Annual Income
Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program?
Yes
No
Is your family receiving Supplemental Security Income (SSI)?
Yes
No
Is your family receiving services from WIC?
Yes
No
Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps?
Yes
No
Is at least one parent/guardian an active duty member of the United States military?
Yes
No
Is at least one parent/guardian a veteran of the United States military?
Yes
No
Emergency Contacts
Add Emergency Contact
Child (Applicant)
Under the disability section - this is a child that is currently working with the Area Education Agency and has an IFSP or IEP
First Name (Required)
Last Name (Required)
Nickname
Birthday (Required)
Gender
Female
Male
SSN
Race
American Indian or Alaska Native
Asian
Black or African American
Multi-racial/Biracial
Native Hawaiian/Other Pacific Islander
Other
Unspecified
White
Hispanic
Yes
No
Other Language
American Sign Language
Amharic
Arabic
Chinese
Chuukese
Dinka
English
French
Gujarati
Kiche
Korean
Mai Mai
Micronesia
Mum
Portuguese
Spanish
Swahili
Tigrinya
Twi
Ukranian
Vietnamese
Primary Health Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Other Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Medicaid Eligibility
Not Eligible
On Medicaid
Potentially Eligible
Medicaid Number
Doctor/Medical Home
ABC Dental
Aberdeen Head Start
Access Health
AEA Emily Shuberg
AEA Kathy VanEngen
AEA Lisa Hofmiester
AEA Amanda Bengston
AEA Amy Legg
AEA Amy R. Louters
AEA Amy Thompson
AEA Ann Hardy
AEA Anna Schmadeke
AEA Barb Lynch-Howser
AEA Becky Baas
AEA Becky Buckridge
AEA Beth Beeman
AEA Betty Fredrickson
AEA Bev Naelek
AEA Brenda Jenkins
AEA Brenda Langston-Janice
AEA Brenda Neumann
AEA Brenda Newman
AEA Brenna Franken
AEA Cari Clyde
AEA Carnie VanEngen
AEA Carrie Gorman
AEA Chris Kleinschmidt
AEA Cynthia Gaspar
AEA Deb Severson
AEA Denise Lundell
AEA Elana Shinkl
AEA Emily Majeres
AEA Eric Weichers
AEA Erin VanderVeede
AEA Fanelda Westphalen
AEA Gina West
AEA Giner Ebel
AEA Gloria Collins
AEA Heather Crichton
AEA Jane Henders
AEA Jared Acl
AEA Jean Larson
AEA Jennifer Corporon
AEA Jessica Niles
AEA Jill Sheehan (Abrahamson)
AEA Jo Michealson
AEA Joa Hohe
AEA JoAnn Walsh
AEA JoAnne Hohl
AEA Juan Walsh
AEA Judy Turner
AEA Julie Cunningham
AEA Julie Wegner
AEA Karen Diaz
AEA Karen Moss
AEA Kathy Fi
AEA Katie Caven
AEA Katie Gorman
AEA Kecia Hickman
AEA Kim Blankespoor
AEA Kim Metzgar
AEA Krista Harpenau
AEA Kristen Nelson
AEA Kristi Jewell
AEA Larry Vis
AEA Laura Allen
AEA Laura Burke
AEA Laura Leonard
AEA Leah Harrima
AEA Liz Lockwood
AEA Lynn Bernard
AEA Martha Draayer
AEA Mary Kallsen
AEA Maya Sanchez
AEA McKenzie Clouse
AEA Melissa Bou
AEA Melissa Puhrmann
AEA Melissa Stomer
AEA Meriele Wilmot
AEA Monson, M
AEA Nancy Bromme
AEA Nancy Kielhold
AEA Nancy Mack Vogt
AEA Nancy Turek
AEA Nancy Wickse
AEA Netty Vansur
AEA Pam Megill
AEA Pat Basye
AEA Patricia Jan
AEA Paula Germann
AEA Pennie Tesch
AEA Rachel Hengeveld
AEA Rebecca Young
AEA Richard Misk
AEA Rose Owens
AEA SARA LINCOLN
AEA Shari Freeman
AEA Sharon Prolifka
AEA Sheila Finch
AEA Sheila Jacobson
AEA Stephanie He
AEA Sue Muran
AEA Susan Kayser
AEA Susan Leusiek
AEA Suzanne Nelson
AEA Tanya Schroeder
AEA Tara Vonk
AEA Teri Porter
AEA Tina Finch
AEA Tina Jensen
AEA Twyla Korthals
AEA Vicky Brodale
AEA Vicky Meyer
Akron Medical Center
AKRON PEDIATRICS (OHIO)
Alcester Clinic
AMG McGreevy Sioux Falls
AMG Rock Rapids
AMG Via Christi Pediatrics
Anthon Mercy Medical
AVERA ABERDEEN
Avera Health Sioux Falls
AVERA LAKES FAMILY PRACTICE
Avera Medical Group
AVERA PEDIATRICS
AVERA ROCK RAIDS
Avera Rock Valley
Beaver Eye Care
BLANK CHILDRENS PEDIATRIC CLINIC
BOYS TOWN HOSPITAL
Bruening Eye Specialists
Buena Vista Regional Med Clinic
Burgess Clinic
Canton Physicians/Mercy Medical
CDC Special Donation Monies
Center for Family Medicine
CHEROKEE FAMILY PRACTICE
Cherokee Public Health
Cherokee Regional Med Clinic
Cheyenee Regional Med Center
Child Health Speciality- Spencer
Child Health Specialty Clinic
CHILDREN'S HOSP OMAHA
CHILDREN'S OF MINNESOTA
Coastal Children's Clinic
Columbus Family Practice
Crawford County Clinic
Crittenton Center
Dakota Allergy And Asthma
Dakota Dunes ENT
Dawn Erickson - Dental Hygenist
Dawn Ericson I Smiles Program
Denison Community Health
Dr Aldrich/Siouxland OBGYN
Dr Ali/Renal Associates
Dr Alndrawis/Morningside Clinic
Dr Amundson
Dr Anderson/Sioux Center Health
Dr Aquino
Dr Arain
Dr Archer/Unity Point
DR ARIC WALTZ
Dr Ashley Powell
Dr Barber/BV Clinic/Tri-Mark
Dr Barden
Dr Barto
Dr Bauer
Dr Beaver
Dr Bechtold/Morningside Family
Dr Beck/Prairie Pediatrics
DR BEECHER
Dr Beireis
Dr Billings
Dr Bosch/Sanford Clinic
Dr Boyle/Sanford
Dr Brawley
Dr Brenner
Dr Brungman
Dr Burchett
DR CALAMINE
Dr Caldwell/Prairie Pediatrics
Dr Cara Drew
DR CAROL BYRD
Dr Ceynow/Sandford Luverne
Dr Chesley
Dr Chesley/Sanford Luverne
Dr Clemens/Orange City Health
Dr Clousing/Promise
Dr Crabb
Dr Crabtree/Sanford Luverne
Dr Crampton/Horn Physicians
Dr Creech/Avera
Dr Crippen/Unity Point BV
Dr Daggett/ Hawarden Family Prac
Dr Daniels/Family Health Center
Dr Danner/Dakota Dunes Family
Dr Dansie/ Family Practice Cente
Dr Davidson
Dr DeGroot/OCAHS
Dr DeJong/Sanford
Dr Devick
Dr Dickman/ Onawa Family Prac
Dr Dodge/ Horn Physicians
Dr Donelan/Sanford
Dr Dudley/ Onawa Family Practice
Dr Earlywine
Dr Eastman/Siouxland OBGYN
Dr Elliot/ McGreery Clinic Avera
Dr Else
Dr Ensz
Dr Faldmo/ Siouxland Comm Health
Dr Feldmann/ Avera Spencer
DR FERGUSON
Dr Flickama/ McGreevy Clinic
Dr Folchert
Dr Folkert
Dr Freese/ Correctionville Fam.
Dr Gamache
Dr Geha/ Floyd Valley Clinic
Dr Glienke
Dr Gohman
Dr Gordan/ Sioux City Family
Dr Graeve
Dr Grant/ Unity Point
Dr Greene/ Hegg Memorial
Dr Grossman/ Orange City Clinic
Dr Halbur
Dr Hamon
DR HANA NIEBUR
Dr Harder
Dr Harrison/ CRMC
Dr Harvey/ Hawarden Family Med
Dr Hatten/ Family Healthcare
Dr Hearns
Dr Heaton/ Siouxland Comm Health
Dr Henry
Dr Hickman
Dr Hicks
Dr Hoffman
Dr Holcomb/ FVH
Dr Holtz/ Siouxland OBGYN
Dr Hooyer/ Sioux Center Clinic
Dr Hornback
Dr Horstman
Dr Huisenga/Unity Point
DR HUNT
Dr Ihrke
Dr Ingram
DR JANSSEN
Dr Jennings/ Morningside Medical
Dr Johnston
Dr Jones
Dr Jongewaard
Dr Jorgenson
Dr Joyce
Dr Kamstra/ OCAHS
DR KAPPENAMAN
Dr Kay Blessington
Dr Keller
Dr Kellogg
Dr Kenny
DR KEROS
Dr Klein/ Sanford
Dr Kleinhesselink/ SCMC
Dr Koelywen/ SCH
Dr Kooima/ McGreevy Clinic
Dr Korver
Dr Kosters
Dr Krell
Dr Krohn
Dr Lafleur
Dr Laird/ OCAHS
Dr Lancaster
Dr Lang
Dr Lassen
Dr Lee/Morningside Clinic
DR LEFEBER
Dr Letsche
Dr Lichty
Dr Longval
Dr Lorenz
DR LOTHROP
Dr Loughlin
Dr Luft
Dr Mailloux/Sanford
Dr Maria Cardenas Fernandez
Dr Marinau
Dr Maroun/ McGreeny
DR MC KERCHER
Dr McLaughlin
Dr Meis, Jolene
Dr Meis, Stephen
Dr Meyer
Dr Millard
Dr Mitchell
Dr Moeller
Dr Mogensen
Dr Monte/ Hawarden Family Prac
Dr Moser
Dr Muilenberg/ OCAHS
Dr Mulder, Rosie
Dr Munson
Dr Murray
DR NAJDAWI
Dr Nelson/ McGreevy
Dr Nielsen
Dr Nilles
Dr Nystrom
Dr Odens
Dr Olsen
Dr Ostercamp
Dr Pals/ OCAHS
Dr Parker
Dr Parmalee/ FVH
Dr Patel
Dr Pearson
Dr Perea
Dr Peterson
Dr Pomerenke
DR PRATT
Dr Prince
Dr Provencal, NP
DR RANNIGER
Dr Rayborne
Dr Rehan/ Prairie Peds
DR REIF-ELKS/FAMILY PRACTICE CEN
Dr Rens
Dr Rhode
Dr Rice
DR ROBERT FESER
Dr Roetman
Dr Roge
Dr Ronfeldt
Dr Rule
Dr Runquist/ Prairie Peds
Dr Rupp
Dr Sather/ Avera
Dr Schenne
DR SCHMELFENIG AVERA MC GREEEVY
Dr Schoenfelder
Dr Schroeder/ LeMars Optometric
Dr Schuller, OCAHS
Dr Schultz
Dr Schyver/ Northside
Dr Searcy
DR SERGIO MIJANGOS
Dr Shepherd
Dr Shepherd
Dr Shook/ Family Health Care
Dr Shriver/ Northside
Dr Sinnott
Dr Slice/ Hegg Memorial
Dr Smith
Dr Smutzer
Dr Soenen
Dr Sorenson
Dr Specht/ FVH
Dr Spora
Dr Springer
Dr Stitt
Dr Stoelting
Dr Strub
Dr Sturdevant
DR SUH
Dr Taylor
Dr Teggatz
Dr Tentinger
DR TESORO
DR TILLEY
Dr Timock, MD
Dr Toben
Dr Todd
Dr Tufty
Dr Tumpkin
Dr Turek, OCAHS
Dr Uhl
Dr Uthe
DR VAN DE GRIEND
Dr VanBeek
Dr VandeLune
Dr Vanderkooi
Dr Vanderlune/ Cherokee Regional
Dr VanEs
Dr VanHill/ Sanford
Dr Veit
Dr Veltri/ Horn
Dr Vis/ Sanford
Dr Vitamvas
Dr Votta/Unity Point
DR WADDELL
Dr Wagner
Dr Walborn
Dr Walker
Dr Wallinga
Dr Watson
Dr Webner
Dr Weinachat
Dr Wellendorf
DR WILFREDO VELOIRA
Dr Wolff, David
Dr Woodall
Dr Woolen
Dr Wu
Dr Wulfekuhler
Dr Zollele/ Unity Point
Dr Zylstra/ Sanford
Dr. Chapman
Dr. Patel
Driesen Eye Clinic
DUNES ENT
ENT CONSULTANTS
Exact Eye Care
Eye Mart Express
FAMILY EYE CARE
FAMILY EYE CARE ORANGE CITY
Family Eye Care- Ida Grove
Family Health Care- Indian Hills
Family Health Care- Siouxland
Family Healthcare Care - Northsi
Family Healthcare Morningside
Family Medical Clinic- Onawa
Family Medicine CLinic
Family Medicine Clinic- Marcus
Family Vision Center
Floyd Valley Medical Clinic
FVH Erin Schroeder
GREATER PRINCE COMMUNITY HEALTH
Groetken Family Eye Care
GROETKEN FAMILY EYE CARE
Harlan Medical Clinic
Hawarden Family Eyecare
Hawarden Family Practice
Hawarden Medical Clinic
HAWARDEN REGIONAL HEALTH CARE
Hawarden Regional Medical Clinic
HEATHER JOHNSON
Hegg Memorial Clinic/Hospital
Horn Physicians
HOSPERS MEDICAL CLINIC
HOSTEIN MEDICAL CLINIC
Hull Medical Clinic
Ida Grove Family Health
Ireton Medical Clinic
KENNEDY CHIROPRACTIC
Kingsley Medical Clinic/ Mercy
Lake City/Stourt Medical
Larchwood Medical Center
LEMARS EYECARE
Lisa Hofmeyer
Luverne Clinic/Sanford
MARCUS EYECARE
Marcus/Cherokee Regional Med Cli
Mason City Ped Clinic
Mayo Clinic
McCrary Post
McFarland Clinic Carroll
Mercy Clinic Anthon
Mercy Medical Center/Anthon
Mercy Medical/ South Sioux City
Mercy Singing Hills Family Medic
Mercy Waukee Medical Clinic
MercyOne Cherokee Family Medicin
MIA TARDIVE SLP
MIDWEST ENT
Mill Creek Family Practice
Mobridge Medical clinic
MORNINGSIDE ENT
Morningside Family Healthcare
Morningside Family Practice
MOUNTAIN PARK HEALTH CENTER
NEIGHBORCARE HEALTH
NEWTON CLINIC
NIEGHBORCARE HEALTH
Northland Family Practice
Onawa Family Clinic
ONE WORLD
Orange City Area Health System
Outpost Optical
PED CTR OF SOUTHWEST LOUISIAN
Pediatric ophthalmology associat
Plymouth County Eye Care
Praire Peds
Promise Community Health
RABBITT FAMILY EYECARE
Sac City Med Clinic
SAINT EDWARD MEDICAL CLINIC
Salina Family Healthcare
Sanford - Luverne
Sanford - Worthington
SANFORD CANTON INWOOD CLINIC
Sanford Children's Specialty
SANFORD CLINIC BOYDEN
Sanford Clinic- Sheldon
SANFORD ENT
Sanford Hospital- Sioux Falls
SANFORD SANBORN
Sanford- Rock Rapids
SERGEANT BLUFF EYE CARE
Sheldon Eye Care Center
Sheldon Family Practice
SHOPKO VISION
Sibley Clinic/ Avera
Sibley Eyecare
SINEK VISION CLINIC
SIOUX CENTER COMM HOSPITAL
Sioux Center Health - Hawarden
SIOUX CENTER HEALTH HAWARDEN
Sioux Center Medical Clinic
SIOUX VALLEY HEALTH
Sioux Valley Medical Associates
Siouxland Community Health
Siouxland Community Health/NE
Siouxland Family Healhcare
Siouxland OBGYN
SIOUXLAND WOMENS HEALTH
SPENCER HOSPITAL
SSM Health Dean Medical Group
St Anthony, Carroll IA
STARS Theraputic Riding
Stewart Memorial Hospital
Sunnybrook Family Medical
ThedaCarePhysicians
Trimark - SLBV Clinic
TRINITY HEALTH MINOT ND
United Community Health
united health community
Unity Point - Buena Vista
Unity Point Clinic (Sunnybrook)
UNITY POINT CLINIC POCHANTAS
UNITY POINT DES MOINES
Unity Point Sioux City Ia
UNITY POINT STORM LAKE
Unity Point- Sac City
Unity Point- Sergeant Bluff
UNIV IOWA CLINICS
Vermillion Medical Clinic
VISION CARE ASSOCIATES
VISION CARE CLINIC
VISION CARE CLINIC /DENISON
VISION CARE CLINIC MOVILLE
Vision Care Clinic- Sioux City
WAL MART OPTICAL SIOUX CENTER
Walmart Optical
WALMART OPTICAL STORM LAKE
WIC/CH Client
WOLFE EYE CLINIC
WOMEN'S HEALTH SANFORD
ZCI M Eckstein, MD
Dentist/Dental Home
ABC Dental
ABC Dentistry
Aberdeen Smiles Dental
ADVANCED DENTAL
Aitken Family Dentistry
Applewhite - Worthington
AppleWhite Dental Partners
Aspen Dental
BEN JENSEN DENTAL
Broadway Dental
Canton Dental Clinic
Carroll Dental Clinic
Central Minnesota Pediatric Dent
Children Dental Center/Mason Cit
Childrens Dental Center
CHILDRENS DENTAL CENTRE
Childrens Dental Omaha
Creighton Un. Sch/Dentistry
Dakota Dental
Denison Pediatric Dentistry
Dental Depot
Dentistry CDC
DOWNTOWN DENTAL
Dr Addink/VanEs
Dr Anderson, Dentist
Dr Arron Cleaver-McWilliams
Dr Baer
Dr Baldwin
Dr Barlow
Dr Barr
Dr Beernick/OC Dentistry
Dr Berning
Dr Blysma
Dr Boating/New Hampton IA
Dr Boelter
Dr Bogue
Dr Bokemper
Dr Boyd
Dr Bradner
Dr Brenda Hausman Miller
Dr Brian Smith, DDS
Dr Brown
Dr Brown/ The Dental Office
Dr Bruns
Dr Burhoop/Lakeport Dental
Dr Burnight
Dr Buttermore
Dr Casey Ryder
dr cavity
Dr Ching/Family First Dental
Dr Christopher
Dr Clark
Dr Cloyd
Dr Cork
Dr Croquette
Dr Dahl
Dr Dannenbring
Dr Dave Metz
Dr Dave Motz
Dr Dennis Henrich
Dr DeStigter
Dr Eichwald
Dr Fake
Dr Fedyszyn
Dr Flint
Dr Gardner
Dr Geottsch/ Cherokee Regional
Dr Gertsen/ Canton Dental Center
Dr Giese/ Sergeant Bluff Smiles
Dr Goebal/ Goebal Ped Dentistry
Dr Grabowski
Dr Green
Dr Hansen
Dr Hausman - Miller
Dr Hemmingson/ Dunes Dental
Dr Henrich
Dr Hettinger/Dental Depot
Dr Hoeppner/ Children's Dental
Dr Hoogean
Dr Hoogeveen
Dr Houk/ Ankeny Children's Dent
Dr Howenstein/ Dunes Dental
Dr Huber
Dr Hurst
Dr Irwin
Dr Jeneary
Dr Jespersen
Dr Jewett
Dr Juba
Dr Kappeman
Dr Kehm
Dr Koelling
Dr Kooi
Dr Korver
Dr Koth
Dr Krystal Lego
Dr Kuiper
Dr Kulawik
Dr Kurth/ Northside Med Clinic
Dr Lewis DDS
Dr Lindeman
Dr Lohr
Dr Lussman
Dr McAllister
Dr McCarthy
Dr McKenna, Ryan
Dr McWilliams
Dr Menke
Dr Morshed
Dr Motz
Dr Mulder
Dr Munch
Dr Munilla
Dr Murphy
Dr Murray
Dr Nixon
Dr Oddink/VanEs
Dr Otto
Dr Parks
Dr Paronish
Dr Patera
Dr Paul DeJong
Dr Phelps
Dr Pick
Dr Powell, Robert
Dr Pribil
Dr Prosser
Dr Quattraachi
Dr Rebollozo RDH
Dr Renken
Dr Roed
Dr Ronconi
Dr Russell
Dr Scallon
Dr Schmidt/ Schmidt Pediatric
Dr Schulte
Dr Shaw
Dr Skibinski/ Children's Dental
Dr Slattery
Dr Stephens/ St Luke's
Dr Stevens/ Avera
Dr Strehlow, ROH
Dr Taggart/ Children's Dental
Dr Thayler/ Children's Dental
Dr Thompson/ Thompson & Wiggins
Dr Tiedje
Dr Tjeerdsma/ Promise
Dr Toft
Dr Troia
Dr Uribe/ Estes & Boelink
Dr Vanderberg
Dr Vanderfeen
Dr VanderZee
Dr VanEs
Dr Vinh Nguyen
Dr Walton
Dr Weber
Dr Weelock- Weelock & Bursick
Dr Welsh
Dr Whiting
Dr Wiggens- Thompson & Wiggens
Dr Williams
Dr Winterholler, Cody
Dr Wohlrabe
Dr Zimmerman
Dr Zwart- Joiner & Zwardt
Dr. Koth
DrBorer/Sheldon Family Dentistry
Dunes Dental 4 Kids
Embrace Dentistry
Estes & Boeyink
FAM 1ST STORM LAKE
FAMILY DENTAL CENTER DUNES
Family Dental Center of Mornings
Family Dental/Storm Lake
Family First - Lake View, IA
Family First - Sac City
Family First Dental- Hawarden
Family First Dental- Primghar
Family First of Storm Lake
Family First- LeMars
Family First- Sioux City
Fort Dodge Community Health
Great Plains Dentistry
Helgevold & Paronish
Holland Dental Clinic
HOUSKA DENTAL CLINIC
HURST FAMILY DENTISTRY
I-Smiles CPH
Jeneary Dental - Cherokee
Joiner/Zwart Dentistry
Katelyn Ward RDA
Kingsley Dentistry
Lake View Family Dentistry
Lakeport Dental
LeMars Dental Center
Lilly Family Dentistry
LLouscher Family Dentistry
Lohr Family Dentistry
Madison Family Practice
Marcus Dental
Morningside dental
My Pediatric Dentist - Bayliss
NEIGHBORCARE HEALTH
Neighborhood Dental
NIEGHBORCARE HEALTH
North Sioux Dental Center
Orange City Dentistry
Parkersburg Family Dental
Patera Family Dentistry
PEDAITRIC DENTISTRY DENISON
Promise Community Health
Rider Family Dentistry
Rochester Ped Dentistry
Rock Valley Dental
Schmidt Pediatric
Sergeant Bluff Dental
Sheldon Dental Office
Sioux Center Dental
Siouxland Community Health
Siouxland Community Health/NE
Siouxland Dental Health
Siouxland District Health Dept
Small Smiles
SONRISA FAMILY DENTAL
Spencer Pediatric Dentistry
Storm Lake Dentistry
Summit Dental- Sioux City
Summit Dental- South Sioux City
Summit Dental- Vermillion
Sunny Brook Dental
Thompson & Wiggins
Today's Family Dentistry
Tri-State Dental
United Community Health
UNIV NEB MED CENTER
Vance Thompson Vision
Vermillion Dental Health
Westown Pediatric Dentistry
Wheelock/Bursick Dentistry
Winnebago Dental Clinic
Does your child have a disability or do you have any concerns about your child's development?
Yes
No
Is there anything else you want to tell us about your child?
Location Preferences
Which program are you applying for? (Required)
Other 2023-2024
Ida Grove SHIP 2023-24
Head Start 2023-24
State Funded EHS 2023-2024
Early Head Start 2023-2024
Head Start Preschool
Free Preschool for Children ages 3 to 5
1st Location Preference
<p></p>
2nd Location Preference
<p></p>
- Your Address
- Available Locations
Click a location on the map to see more info
Click here
to find a provider in your area.
Additional Applicant
Do you want to apply now for another child in your family?
Add Another Applicant
Siblings
Are there other children in the family?
Add a Sibling
Thank you for your interest in the Early Head Start, Head Start or CDC programs. Please click submit to finalize your application. We will contact you to set up an intake appointment.
Required information is missing, see above.