Early Head Start serves children up to the age of 3 years old and pregnant women. Please complete each field below entirely if you are interested in applying for Early Head Start. If you have a child that is age 3 or older, they are ineligible for our services and may be eligible for Head Start. If you live in Grant County, contact Marion Community Schools Little Giants at 765-651-2080. If you live in Blackford County, contact Community and Family Services at 260-726-9318.
Parent/Guardian
Fill out the information below for the "primary adult" in the family who has custody of the child applying for services.
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.
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Bengali
Chinese
English
Hindi
Korean
Odiya
Punjabi
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
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
Address
Fill out the below information for where you are currently living. If you are experiencing homelessness, fill out an address where you are able to receive mail.
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
Fill out the information below for the "secondary adult" in the family who has custody of the child applying for services. This adult must be living with the family to be included in the application.
Is there another parent/guardian in the family?
Yes
No
First Name (Required)
Last Name (Required)
Birthday (Required)
Gender
Female
Male
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.
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Bengali
Chinese
English
Hindi
Korean
Odiya
Punjabi
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
Employment Status
Full-time & Training
Full-time (35 hours/week or more)
Part-time & Training
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
Child (Applicant)
Fill out the information below for the child applying for services. This child must be under the age of 3 years to be served by Early Head Start.
First Name (Required)
Middle Name
Last Name (Required)
Suffix
Nickname
Birthday (Required)
Gender
Female
Male
Primary Health Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Doctor/Medical Home
About Special Kids
Advantage Home Health Care
American Health Network Marion
American Health Network- Muncie
Ascension Med. Group Heart Care
Ascension Medical Group
Ascension St. Vincent Health ENT
ASV Ear, Nose, & Throat Center
Audiology Clinic- Ball State
Barstow Community Health Center
Behavior Associates
Bluffton Med Group Peds
Bluffton OB/GYN
Bluffton Regional Medical Center
Breast Ed/Screening/Survival
Bridges to Health
Broadway Family Medicine
Bronson LakeView Pediatrics
Bunnell Family EyeCare
Bureau of Dev. Disabilities Serv
Burtea, E. Diana, MD
Bwatwa, Jeremiah, MD
Byrn, Robert, MD
Cancer Services of Grant Co.
Care Center at the Tower
Center for Deaf and Hard of Hear
Central Indiana Orthopedics
CHI St. Vincent Prim. & Con.
Children's Special Health Care
CHS Pediatrics
Cincinnati Children's Hospital
Colonial Oaks Health Care Cnt.
Com. Phys. Net. Pediatric Care
Comm. Phys. Network- Fam. Med.
Community Family Physicians
Community Health Pavillion East
Community Hospital Anderson
Community Howard Hospital
Community Phys. Net. OB/GYN
Community Phys. Net. Peds Fisher
Community Physician Net. OB/GYN
Community Physician Network ENT
Community Physician Network- Ind
Community Physicians Net. OB/GYN
Community Physicians Network Ped
Cranial Technologies
Cytrynowicz, Karl, DO
Downs, Denise, MD
Dr George
Dr. Abdul Syed MD
Dr. Alice Butterworth, DDS
Dr. Bhoopaulum
Dr. Cami Barger-Jones MD
Dr. David Moore, MD
Dr. Doris Jesch MD
Dr. Holbreich
Dr. Jon Blake MD
Dr. Tim Gillum
Drook Medical Center
Early Hearing Detection Interven
Easterseals Crossroads
ECHO
Eley, DR.
Ensley OB/GYN
ENT Associates/Dr. Reddy MD
Eskenazi Health
Eye Associates Group, LLC
Family Birthing Center@MGH
Family Medicine Residency Center
Family Optometry Marion
Family Practice Of Elwood
Farmer, Steven, MD
First Steps Blackford County / H
First Steps Grant County
First Steps South East
Fishers Pediatrics
Franciscan Health Indianapolis
Furr, Amanda MD
Gas City Medical Center
Goodman Campbell Brain and Spine
Grand Lake Family Practice/Peds
Great Beginnings
Haendiges, Michelle, MD
Halloran, Patricia, NP
Hanger Clinic
Hartford Preferred Physicians
Hartmann, Christy, MD
Health Dept. Blackford County
Health Dept. GC
Health Ed Pros
HealthNet/ Care Center
Healthy Grant County Website
Healthy Horizons Pediatrics
Helping Hands Pregnancy Resource
Hendrix, Dr. Carrie
Homefront
Hometown Hearing and Audilogy
Hoosier Indiana Plan (HIP)
Hoosier Sport and Chiropractic
Hoover, Dr. Andrea
Hopebridge
Hott, Steven, MD
IHC Kokomo
IN Deaf-Blind Services Project
IN School for the Blind and VI
IN University Blackford Hospital
Indiana Health Center- Kokomo
Indiana Health Centers, Inc.
Indiana Hemophilia / Thrombosis
Infectious Disease Of Indiana
IU Ball Memorial Family Medicine
IU Early Evaluation Hub - Andsn
IU Health Arnett
IU Health Ball Memorial Hospital
IU Health BMH ENT/Otolaryntol.
IU Health BMP Upland
IU Health Hartford City
IU Health Jay Family Practice
IU Health Nephrology North Merid
IU Health Network Hartford City
IU Health Orthopedic Medicine
IU Health Plastic Surgery
IU Health Primary Care Muncie
IU Health Women's Health
IWU OT Department
J. Pauley Health Center- Indy
Jane Pauley Community Health
Jones, Kia MD
Kidd, Baron, MD
Kids ENT
Labor Ready
Lee, Thomas Dr.
Lilla, Josephine, MD
Litz, Mark, Dr.
Living Forward
Logansport Pediatrics
Longe Vision Center
Lutheran Hospital
Macomb Medical Pediatrics
Mapara, Zohair, MD
March of Dimes - Indiana
Marion Eye Center
Marion Family Planning Center
Marion Family Practice
Marion General Hospital
Marion Health (Formerly MGH HIM)
Marion Home Medical Supplies
Marion Pediatrics
Marion Pediatrics
Marion Primary Care
Martindale Brightwood Clinic
McKinney Pediatrics, PA
Medi-Share
Medical Group BC
Meridian Health Pediatrics
Meridian Health Services
Meridian MD Dunkirk
Meridian Pediatric Rehab
Meridian Women's Health
MGH Lactation Consultation
MGH Pediatric Center
MGH Work Solutions
MHP Family & Internal Medicine
Midwest Child & Ado. Specialty
Midwest Eye Consultants
Midwest Eye Institute
Midwest Orthotics
Minority Health Coalition
Mommy Xpress
Morse, Jessica, DO
Myron, Stephen, MD
NCA Therapy
Neighborhood Health Clinics, Inc
Nesbitt, Lindsay, MD
Nisa, Nuzhat, MD
Noblesville Pediatrics
North Central IN First Steps
North Central Indiana Pediatrics
O'Banion, Eric, MD
O'Brien Psychological Services,
O'Brien, Mark, MD
Obstetrics & Gynecology of IN
Obstetrics & Gynecology Of MGH
Open Door Health Serv. Anderson
Open Door Health Services Muncie
Operation Kids Sight Conserv.
Paintsville Pediatrics
Panola Medical Group Ped. Clinic
Parkview Health Pediatric Rehab
Parkview Health Specialty Peds
Parkview Huntington Family Pract
Parkview Huntington Hospital
Parkview Pediatrics Huntington
Parkview Peds Illinois Road
Parkview Physicians Group Wabash
Parkview Regional Medical Center
Passal, Donald, MD
Patti Osborne
Pavilion Pediatrics
Pediatric Advocates
Pediatric Associates of Argyle
Pediatric Center Marion Health
Pediatric Diabetes & Endocrin.
Pediatric Rehab @PMH
Pence Davis Medical Center
Penobscot Pediatrics
People's Health Center
Perry, Kirk Dr.
Peterson, John, MD
Philippsen, Luke, MD
PMCH Cardiology @ ST. Vincent
PMCH Ear Nose and Throat Center
PMCH Elwood Pediatrics
PMCH Neurobehavioral
PMCH Pediatric Rehab
Positive Results for Kids
PPG Maternal Fetal Medicine
PPG OB/GYN Huntington
PPG OB/GYN Midwives
PPG Pediatric Cardiology
PPG Pediatrics Huntington
PPG- OB/GYN Carew St.
PPG- Pediatrics Carew St
Preferred Eye Care
Preferred Family Physicians
Pregnancy Plus Anderson
Prevail
Progressive Cancer Center
Riegle, Helen, MD
Riegle, Shannon, MD
Riggs Community Health Center
Riley Audiology
Riley Burn Program (Eskenazi/IU)
Riley Cardiology
Riley Cystic Fibrosis Clinic
Riley Developmental Peds
Riley Hosp. ENT Outpatient Clini
Riley Hosp. for Children at IU
Riley Hospital Peds Nephrology
Riley Hospital Sleep Clinic
Riley Hosptial Pulm./All./Immun.
Riley Outpatient Urology
Riley Ped. Gastroenterology
Riley Pediatric Neurology
Riley Pediatric Ophthamology
Riley Pediatric Surgery
Riley Physicians Hema/Oncology
Riley Physicians Peds- Muncie
Riley/ Neurosurgery
Riverview Health
Roberts, Dr. Gavin
Saleh, Mary, MD
Serenity Pediatric Therapies
Services For V/H Impaired
Shrine, Mizpah
Shriners Hospital for Children
Sky Park Pediatrics
Southwest Health & Dental Center
Speech Language Clinic
Srishti, Aparna, MD
St. Joseph Regional Med. Center
St. Vincent Audiology Fishers
St. Vincent Medical Group OB/GYN
St. Vincent Subspecialties Neuro
St. Vincent Women's Hospital
St. Vincent- Anderson Peds
St. Vincent- Central IN ENT
Stalker, Neil, MD
Stewart, Thomas, MD
Sumabat, Washington, MD
Templin, Teresa, NP
Thieme, Laura, MD
Transcend Orthotics & Prosthetic
UF Health Jacksonville - Shands
Upland Health & Diagnostic Cente
Voges, Katherine, MD
Voss Center for Women
Wabash County Health Department
Wasseem, Shamaila, MD
West Jay Clinic
Whishard Hispanic Health Res.
Wolfe, Paul, MD
Yakima Valley Neighborhood Healt
Zolman, Melanie FNP
Dentist/Dental Home
Adolescent & Pediatric Dentistry
Advanced Family Dentistry
Aspen Dental
Aspen Dental- Muncie
Bluebonnet Dental
Brown, Edwin DDS
Bruner Dental
Butterworth, Alice, DDS
Catey Williams Dental
Cherry Tree Dental
Cool Smiles
Courter, Nyla Jo, DDS
Cox, Charlie, DDS
Delaware Dental Solutions
Dr McGee DDS
Dr. Alice Butterworth, DDS
Dr. Jaime Lemna DDS
Dr. Jeff Rector DDS
Dr. Laura Kukelhan, DDS
Dr. Lisa Strieter DDS
Dr. Matthew Maddox, DDS
Dr. Robert Long, DDS
EHS Dental Survey
Evans, Rob E., D.D.S.
Evanseck, Richard, DDS
Family Dental - Dr. Beck
Gorman Center For Orthodontics
Hoosier Pediatric Dental Group
Hoosier Pediatric Dental Group
Hoover, Jack, DDS
Hott Family Dentistry
Huntington Dental Group
Indiana Health Center
Ireland, Heather, DDS
Johnson, Pamela, DDS
Kelly, Stuart, DDS
Kokomo Pediatric Dentistry
Ladd Dental Group Wabash
Lifetime Smiles
Marion Family Dental
McGee, Charles, DDS
Mercho, James, DDS
Meridian Dental
Mitthoeffer Family Dental
Mobile Dentist
Muncie Pediatric Dentist
Munson, Ronald, DDS
Newman Family Denitstry
Nicholson Family Dental
Open Door Dental Clinic
Ossian Dental
Pate, Matthew, DDS
Pediatric Dentistry
Progressive Dental Center
Refresh Dental
Reid, Amber, DDS
Riley Hosptial Pulm./All./Immun.
Simpson, Gerald, DDS
Smith, Glenn, DDS
Sneed, Clifford, DDS
Southwest Health & Dental Center
Steele Pediatric Dentistry
Steele, David, DDS
Stoney Creek Family Dental
Suding, Eric, DDS
The Dental Place
The Rector Dental Group
The Smile Center
Weddell Pediatric Dental Special
Wisler Dental
Youthful Smiles Family Dentistry
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)
EHS 2022-2023
Home Visiting or Classroom for pregnant women and children to age 3
1st Location Preference
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2nd Location Preference
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- 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 Early Head Start. Make sure to click submit to finalize your contact sheet. A staff member will be in contact with you shortly to set up an intake appointment.
Required information is missing, see above.