Planting Seeds for The Future Dear Families: Thank you for interest in Le Jardin Community Center Program. To qualify for our services your child must be age eligible and your family must either be income or categorically eligible.
Parent/Guardian
Complete all the information
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.
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
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Creole
English
Other
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
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 & 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
Custody
Yes
No
Lives with Family
Yes
No
Provides Financial Support
Yes
No
Teen Parent
Yes
No
If Teen Parent, Subsidized?
Yes
No
Address
Please fill all the fields (If your address changes during the year, you are responsible for letting us know)
Is your family experiencing homelessness?
Yes
No
Living Address (Required)
Address Line 2
City (Required)
State (Required)
ZIP (Required)
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to find a provider in your area.
Mailing Address same as Living Address
Mailing Address
Address Line 2
City
State
ZIP
Additional Parent/Guardian
Complete all the information
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
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Creole
English
Other
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
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 & 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
Custody
Yes
No
Lives with Family
Yes
No
Provides Financial Support
Yes
No
Teen Parent
Yes
No
Family Information
Complete all the information
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
Creole
English
Other
Spanish
Is another language being acquired or learned at home?
Yes
No
Number in Household
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
WIC ID (if applicable)
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)
Complete all the information
First Name (Required)
Middle Name
Last Name (Required)
Birthday (Required)
Gender
Female
Male
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
English Proficiency
Little
Moderate
None
Proficient
Other Language
American Sign Language
Creole
English
Other
Spanish
Other Language Proficiency
Little
Moderate
None
Proficient
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
Insurance Number
Medicaid Eligibility
Not Eligible
On Medicaid
Potentially Eligible
Medicaid Number
Doctor/Medical Home
A. San Roman
ABC Pediatrics PA
Access Medical FL CI
Access medical west kendall
Acevedo Medical Group
Adam M. Stuart
Adam Steward
Adriana Rojas
Alanna Sedor
Alberto Dominguez
Alejandro J. Martinez, MD
All Family Care Center
Altima Dental Group
Alvaro Dangond
Ana julia Md. contreras
Andrea Assantes
Ann Fernandez
Armando Acosta
Armando Blanco
Assad Mojtabaee
Ausome Foundation
C. Alonzo
C.ANNA MCCONNELL, M.D.
Camilo Zambrano
Carlos Fuster
Carmen M. Alfonso
Carolina Villanueva
carolina villanueva
Cecilia Morales
Center for Pediatric Care Inc
Chamberlain University
Charles Augustus
CHI
CHI South Miami Health Center
CHI Tavernier Health Center
CHI-Medical Mobile Van
Christian Flores
Claudia Arango MD
Claudia Herrera
CMG Florida City Pediatric Cente
Community Health of South Florid
Community Medical Group
Community Medical Group Of West
community medical group-perrine
Continuacare Medical Center
Conviva Krome
coral gables pediatric associate
Cranial Technology
Cuan Damarys
DADE CHD
Danette Torres
Dean Katzi
Diana E Vargas
Doctors Medical Center
DORIS ISON S DADE
Dorsey Goosby
Dr. Sidiq Aldabbagh
Dr. Adrian T. Marimon
Dr. Alberto Dominguez
Dr. Amelia Armas
Dr. Bridges
Dr. Claudia Cabanas
Dr. Constantin Nikitin
Dr. Damaris Mafut
Dr. Dorian
Dr. Francisco R. Jimenez
Dr. J. Schapiro
Dr. Jimenez
Dr. Julio Arronte MD
Dr. Laura Echeverria, DDS
Dr. Lorilee A Graham
Dr. Mario Gomez
Dr. Maritza Vilas-Rivas
Dr. Martha Vidas Rivas
Dr. Pablo Delgado, M.D.
Dr. Puig
Dr. Ronald Sanetta
Dr. S. Ojeda Gil
Dr. Sabriya Ishoof
Dr. Sergio F. Alzugaray
Dr. Stanley M. Zuba
Dr. Susan Fox
Dr. Zafar I. Qureshi, Md
Dr.Dalbert
Early Head Start
Edwin Cordero
Eileen Kiang DO
elena sweet
Elier tinoco
Elise Davila Torres
Emilio H. Lopez, M.D.
Emma b Simmonds
Ennio M Colon
Erick Bustamante
Evelyn Navas
Evelyn Rivera
Fady I Castro
Family Dental
Family Planning Clinic
Fit Life Pediatric Consultants
Florida Department Of Health
Florida Keys Pediatrics
Francesco Cabrera
Francisco Martinez
Fruity Veggie Nutrition
Gadsden County Medical Clinic
Glauco Puig
Good News Care Center
Head Start Staff
Health Department
Health Management System
Healthy Children Pediatrics
Hear 4 Kidz, Inc.
Helgemo & Liou Pediatrics
Hilda Tejero MD
Homestead Medical Clinic
Homestead Pediatric Associates
Idania Hurtado
Ileana Romero Bolumen
IMC-Flagler East
Interamerican Medical Center
Iran Niroomand-Rad, DO
Jackson Health System
Jackson Health Systems
Jackson Memorial Hospital
Jakcson Memorial Hospital
Jemell Walker
Jessica Tufino
Jesus Ornelas MD
Jose Acosta
Jose Azaret
Jose de los Santos
Jose Fernandez
joseph rufus MD
Justin Jeter
K. Van Kirk
Kendall Eye Institue
Kendall Ped General
Kenia Martinez
Kevin Fox
Kidz Pediatric Multispeciality G
Kim Bango
Kings Bay Pediatrics
Leidiana Figueroa
Leon Martinez
Leon Salgado
Leonore Noel
Lievano perez
Linda Zambrana
Lions Club Vision
Lisa Perez
Little Haiti Health Center
Liuska Mariscal
Lopez - Guerrero Rene
LPG Pediatrics-Page Field
Luiz Saenz
Luz Pages
Lyndsey Burton MD
M. Fernandez
M. Milla
M. Nicolas-Alexandre
M. Oglesby
M. Selem
M. Shahmoamady, M.D., P.A.
Mabel Bohorquez
Magali Selem
Main Street Children's Dentistry
Mairelys Gonzakez Bosch
Manuel A. Lovo
Mardia Ramos
Maria Amador
Maria C. Cubillas
Maria M. Alonso
Maria Perez
Marie Lamarre
Marie Nicolas Alexandre
Mariela Urbina
Marilyne R. Christian
MARIO CARCAMO
Mario Gomez
Mario Guzman
Mario Sanchez
Maritza Vila-Rivas
Martha Lopez
Martha M. Katz
Martin Luther King Pediatric
Marvin J. Rios MD
MD Now Medical Center-Homestead
Miami Beach Pediatrics
Miami Child Hospital
Miami Pediatic Gastro Dr Loret M
Michelle Lopez
Midiala Diaz Iglesias MD
Mitra Shafieian
N. Echegoyen
Navila Cardosa
New Beginning Healthcare
Nicklaus Children's Movil Unit
Nicklaus Children`s Hospital
Nicklaus Mobile Dental Unit
Nicole Fields
Nicole S. Torres M.D
Nilda Acosta
Nivia E. Vazquez
Nizar Dowla
Nora Daniel
octavio Vasconcello-Cohen M.d
Ojeda Gil
Open Door
Oscar Hernandez
P. Shankaraiah
Palmetto Bay
Pavilion for Women's Health
Payal Do Shah
Pedi Mobile
Pediatric Associated
Pediatric Associates
Pediatric Associates
Pediatric Associates of South fl
pediatric mobile clinic
Pembroke Pine Pediatrics-Assoc
pentucket medical river walk
Physicans primary care of SW
Pierre-Richard Limousin
Planned Parenthood
portela
Public Health Trust
Ramon A. Guevara
Ramon Maldonado
Robert O'Neil MD
Roberto Warman,MD
Rodolfo Ferretti
Rolando Penate
Roosevelt De Los Santos Florian
Rosa Junco
Rosario Gely
Ruiz Unger
sandy calle MD
Sargine Dupuy
Scarlet Constant MD
Sebastian Padron
Sedor Alanna
sedor alanna
Serman Ojeda
SFPP South dade
Shalfein Mitra
Sidiq Aldabbagh
Simply Health
SMC Medical Center inc
South Florida Pediatric Group
South Florida Pediatric Partener
South Florida Pediatrics Partner
Southland Mall Dental
Stacy Zide M.D.
Suzette Delgado M.D
Suzzete Gray-Walker
Tanya Roman
Tereza Nodal
The Pediatric Center Inc
The Tooth Place
Thomas J Dimino
Tooth Fairy
Trujillo MD
Tu Clinica Hispana
UHealth Kendall
university Health Care Homestead
University of Florida UF/IFAS
University Of Miami
Vanessa Fuentes
Vicente Lau
Vision Unlimited
w kendall-peds Assoc
Wanda Rodrigue-Guzman
West Kendall Health Center
West Kendall OBGYN
West Perrine Health Center
William Ignacio Muinos MD
Zambrano
Zhephir Medical Group
Dental Coverage
Children's Health Insurance Program (CHIP)
Combined Medicaid/CHIP
Medicaid
No Insurance
Other
Private Health Insurance
State-Only Funded Insurance
Dental Coverage Number
Dentist/Dental Home
A/C Pediatric Dentist
Aldama Dental Group PA
Altima Dental Group
American Pediatric Dental Group
Angelica Cardenas-Mansur D.M.D
Antonio Otero, D.D.S
Children's Dentistry of Homestea
conviva care center
Dental care of south florida
Dental Center of Country Walk
Dental Center of Homestead
Dental CHI
Dental group
Dental Plus
Dental Quest
Dentaquest
DHG AT KENDALL LAKES
Doris Ison Health Center
Dr. Castera
Dr. David Tijerino
Egil dental
Expert smiles center
Ezra Carias
Fady I Castro
Family and Cosmetic Dentistry
Family Dental
Family Dental Center
Family Dentistry of Homestead
Family Plus Dental Center
Florida City Dental INC
Florida Department of Health
Floridian Dental
Gozalo Cortes
Great Expression Dental
Hammocks Dental, P.A
Health Management System
Homestead Family Dental Care
Jackson Health Systems
Janeth Muniz
Jose torres
Juan Quintero
Kendall Pediatric
Kendall Pediatric Dentistry
Lawrence Lathan
Liberty Dental Plan
LITTLE PEOPLE PEDIATRICS
Little Tooth Doctor
Lobaina Dental
Main Street Children's Dentistry
Martin L. King, Dental
Miami Beach Dental Center
Miami Children's Hospital
Miami Children`s Smile
Miami International Mall Dental
Miami Street Children's Dentisit
Michelle Lopez
MS Miami Lakes
Naranja Family Dentistry
Naranja Health Center
Nicklaus Children Hospital
Nicklaus Mobile Dental Unit
Octavio Vasconcello-Cohen
Pedi Mobile
pediatric and adolescent dentry
Pediatric Dental Center
Pediatric Dental Center of homes
Pediatric dental land
Public Library Miami Dade
R. Arosemena
Rolando J. Molina
Smile Plus
South Miami Health Center
Southland Mall Dental
Superteeth Pediatric
The family Dental
The Tooth Place
Tooth Fairy
Towncare Dental Associates of Ho
Towncare Dental of Cutler Bay
Unlimited Dental Care
Vicente Lau
Zorida T Sanchez.D.D.S
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 Grantee 2 2022-2023
EHS Grantee 3 2022-2023
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 you registration!
Required information is missing, see above.